Spectrum of Nd:YAG laser-induced intraocular lens damage in explanted lenses

A series of explanted intraocular lenses (IOLs) and autopsy globes containing IOLs that had previously had Nd:YAG laser posterior capsulotomy were analyzed at the Intermountain Ocular Research Center. A broad spectrum of laser-induced IOL damage was found. In the majority of instances, the damage was classified as mild and consisted of tiny pits on the IOLs' posterior surface. These pits would not be expected to produce any visually significant consequences. Moderate damage consisted of larger, more extensive pitting, craters, and small cracks. The most severely damaged IOLs showed extensive cracking and focal fracturing of the optic. Extensive damage may result in unacceptable visual blurring, distortion, and glare which in extreme cases may warrant IOL explantation, as presented in a case report.