The study aimed to investigate the effects of the ‘inverted U method’ Nd:YAG laser posterior capsulotomy on anterior segment parameters, decentration and tilt of intraocular lens (IOLs) and visual acuity in 76 patients with posterior capsular opacification (PCO) after previous combined phaco-vitrectomy for rhegmatogenous retinal detachment. The parameters including IOL decentration, angle of IOL tilt, anterior chamber angle (ACA), anterior chamber depth (ACD), anterior chamber volume (ACV), central corneal thickness (CCT), keratometry, pupil size, axial length (AL), intraocular pressure (IOP), refractive status, corrected distance visual acuity (CDVA), objective scattering index (OSI) and Chinese version of visual function 14 (VF-14) index were obtained before and three months after capsulotomy. Post capsulotomy, the tilt angle and decentration of the IOLs at both vertical (tilt: p=.004, decentration: p=.029) and horizontal meridian (tilt: p=.001, decentration: p=.017) signiﬁcantly decreased, ACA increased (p=.015); CDVA (p=.000), VF-14 score (p=.000) and OSI (p=.000) were significantly improved. There were a signiﬁcant decrease in cylindrical error (p=.001) and a myopic shift in spherical error (p=.001) after the capsulotomy. No signiﬁcant differences in ACD, ACV, CCT, keratometry, pupil size, AL and IOP were detected (p > .05 for all). The ‘inverted U method’ Nd: YAG laser posterior capsulotomy decreases tilt and decentration of the IOL, increases ACA and causes no change in ACD, ACV, CCT and IOP in patients after phaco-vitrectomy. These changes decrease cylindrical error and induce a myopic shift in spherical error. Laser capsulotomy significantly improves visual acuity.