Neodymium:YAG laser damage of intraocular lenses

Intraocular lenses (IOLs) suitable for implantation were analyzed for the presence of refractile particles. These were found in lathe-cut and injection-molded lenses from various manufacturers. A YAG laser was focused 2 mm beyond the IOLs in a special test chamber and fired through them. The IOLs were then analyzed for damage. A photographically documented study of six IOLs using Q-switched and mode-locked lasers showed optical breakdown occurring within the IOLs; this was not clearly related to refractile particles. Optical breakdown did not occur in two IOLs with a similar number of refractile particles. Damage was seen with the mode-locked but not with the Q-switched laser. The optical breakdown occurred more frequently at high power (5.0 mJ) than at low power (1.2 mJ).