Purpose To evaluate circular neodymium: YAG laser incision in cases of anterior capsular contraction syndrome (ACCS) by comparing it to radial Neody- mium: YAG laser incision as for efficacy and safety. Settings Ophthalmology Department, Benha University Hospitals. Methods The study was done on 74 eyes of 66 patients with symptomatic ACCS. Eyes were ran- domly allocated to one of the two groups. Group I were treated by circular YAG laser anterior capsulo- tomy. Group II were treated by radial YAG laser anterior capsulotomy. All cases passed a full oph- thalmic examination before laser capsulotomy, 1 week, 1 month, 6 months and 12 months after laser. Results BCVA at the 1st week and the 1st month after the capsulotomy did not show any significant difference between the two groups; however at the 3rd and 6th months, the circular group showed better visual acuity than the radial group (p 0.001 and 0.001, respectively). All post-YAG UCVA and BCVA were significantly higher than pre-YAG UCVA and BCVA in both groups. IOL decentration occurred in two cases in radial group. Circular group had significantly higher percentage of contraction