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Case Reports
. 2019 May;98(20):e15720.
doi: 10.1097/MD.0000000000015720.

Haptic fracture and dislocation of polyimide intraocular lens after neodymium: YAG laser capsulotomy: A case report

Jae Suk Kim  1 , Min Ji Kang  1 , Kyeong Do Jeong  2 , Je Hyung Hwang  1
Affiliations
Case Reports

Haptic fracture and dislocation of polyimide intraocular lens after neodymium: YAG laser capsulotomy: A case report

Jae Suk Kim et al. Medicine (Baltimore). 2019 May.

Abstract

Rationale: We report a case of haptic fracture of polyimide intraocular lens (IOL) and its dislocation after neodymium:YAG (Nd:YAG) laser capsulotomy. To the best of our knowledge, this is the first report of both the fracture and dislocation of the IOL after laser posterior capsulotomy.

Patient concerns: A 78-year-old male was referred to our clinic with a history of decreased visual acuity after Nd:YAG laser posterior capsulotomy in the right eye. A dislocated IOL was observed on slit lamp examination.

Diagnosis: On slit-lamp examination, dislocated IOL with intact anterior capsulorrhexis margin was observed in the right eye.

Interventions: We removed the dislocated IOL and fixed a 3-piece IOL (Acrysof MN60AC, Alcon Laboratories, Inc) in the ciliary sulcus under retrobulbar anesthesia.

Outcomes: After the operation, the observed uncorrected distance visual acuity (UCVA) was 20/20 and the measured intraocular pressure (IOP) was 18 mmHg; the IOL was fixed in the ciliary sulcus.

Lessons: Three-piece, silicone-polyimide haptics in IOLs can get fractured after Nd:YAG laser capsulotomy. Thus, it is suggested that sufficient haptic dilation should be ensured while performing Nd:YAG laser capsulotomy in patients with polyimide haptics. Moreover, a small-sized capsulotomy is likely to be helpful in such patients.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Anterior segment photographs at patient's first visit. Dislocated IOL was observed in the right eye. IOL = intraocular lens.
Figure 2
Figure 2
Intra-operative photographs showing fractured polyimide distal haptic.
Figure 3
Figure 3
Fractured haptic of the polyimide intraocular lens after extraction.
Figure 4
Figure 4
Fractured haptic of the polyimide intraocular lens after in vitro neodymium:YAG laser treatment.
See this image and copyright information in PMC

References

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