April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Removal of Surface Deposits on Anterior Intraocular Lenses with a Neodymium-Doped, Yttrium Aluminum Garnet Laser (Nd:YAG Laser)
Author Affiliations & Notes
  • Hiromasa Igarashi
    Department of Ophthalmology, Kushiro Red-Cross Hospital, Kushiro-shi, Japan
  • Yuji Suzuki
    Department of Ophthalmology, Kushiro Red-Cross Hospital, Kushiro-shi, Japan
  • Sachiko Igarashi
    Sakura Eye Clinic, Kushiro-cyo, Japan
  • Eiko Suzuki
    Sakura Eye Clinic, Kushiro-cyo, Japan
  • Footnotes
    Commercial Relationships  Hiromasa Igarashi, None; Yuji Suzuki, None; Sachiko Igarashi, None; Eiko Suzuki, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4720. doi:
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      Hiromasa Igarashi, Yuji Suzuki, Sachiko Igarashi, Eiko Suzuki; Removal of Surface Deposits on Anterior Intraocular Lenses with a Neodymium-Doped, Yttrium Aluminum Garnet Laser (Nd:YAG Laser). Invest. Ophthalmol. Vis. Sci. 2011;52(14):4720.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To improve visual acuity (VA) and ensure a satisfactory funduscopic view by removing accumulated surface deposits and pigment clumps from anterior intraocular lenses (IOLs) after various surgeries.

Methods: : This study included 10 eyes of 10 patients (mean age, 54.3±10.2 years). Three eyes had undergone surgery for a complicated cataract associated with uveitis, four eyes for proliferative vitreoretinopathy, and three for diabetic retinopathy. At least 2 years had passed since the last surgery for all patients, and none had active inflammation. The settings of the Nd:YAG laser (Ultra Q Ophthalmic Laser, Ellex) used for this research were: wavelength, 1,064 nm; energy, 0.6-0.8 mJ; pulse duration, 4 ns; burst mode pulse setting, 1 pulse per shot; treatment beam spot size, 11 µm (full width half maximum, 8 µm); and posterior offset, 150 µm. Although the number of laser shots delivered in each case varied according to the size and number of IOL surface deposits, generally, one shot was delivered per deposit up to a maximum of 30 shots per lens (mean, 22±4.5 shots). The intraocular pressure (IOP) was measured just before and 1, 2, and 24 hours postoperatively. The VA was measured and fundus photography was carried out preoperatively and 24 hours postoperatively.

Results: : Most deposits of all patients were removed completely, which facilitated funduscopy (fundus photography). The IOP increased transiently immediately postoperatively by 1 to 2 mmHg by applanation tonometry (mean, 1.25±0.30) but returned to baseline within 24 hours. One patient had an improved logMAR VA of at least 0.2; four patients had improvements of at least 0.1; and in five patients the VA remained unchanged. All patients reported a subjective visual improvement. Although IOL surface damage is the greatest concern associated with deposit removal using an Nd:YAG laser, there was no crack formation on the IOL surface in any patient.

Conclusions: : IOL surface deposits hinder funduscopy. The Nd:YAG laser allows complete removal of surface deposits without substantial complications and will likely gain widespread acceptance.

Keywords: intraocular lens • laser • cataract 
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