Posterior capsular opacification (PCO) is a common complication after cataract surgery, which is commonly treated using neodymium: yttrium-aluminum-garnet (Nd-YAG) laser capsulotomy. The purpose of this study is to investigate the impact of Nd-YAG laser capsulotomy on retinal and choroidal structures. Thirty-four eyes from 32 patients with PCO were included. Patients underwent Nd-YAG laser capsulotomy, and assessments were performed preoperatively, at 1st week, and 1st month postoperatively. OCT scans were acquired using Swept-source Optical Coherence Tomography (SS OCT). Choroidal thickness (CT) maps within the early treatment diabetic retinopathy study (ETDRS) subfields were obtained. Choroidal Vascularity Index (CVI) was calculated from OCT scans using Image J software. The preoperative, postoperative first week and first month measurements were compared. The mean age of patients was 68.7 ± 8.6 years. Visual acuity significantly improved postoperatively (p <
0.001), while IOP remained unchanged (p = 0.170). No significant change in central macular thickness (CMT) was observed across time points. CVI significantly increased postoperatively (p = 0.004). Choroidal thickness remained stable in most sectors, except for significant reduction in the inner inferior sector at 1 month (p = 0.025). Nd-YAG laser capsulotomy did not affect central macular thickness but caused localized change in choroidal thickness. Increased CVI was found which may be linked to postoperative inflammation. These findings suggest capsulotomy may affect choroidal structure and vasculature.