Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
IOL surface deposits hinder funduscopy. The Nd:YAG laser allows complete removal of surface deposits without substantial complications and will likely gain widespread acceptance.
This PDF is available to Subscribers Only