NEODYMIUM-YAG LASER DAMAGE ON SILICONE INTRAOCULAR LENSES - A COMPARISON OF LESIONS ON EXPLANTED LENSES AND EXPERIMENTALLY PRODUCED LESIONS

In this study we examined 17 explanted silicone intraocular lenses (IO Ls) (two one-piece, 15 three-piece) that had evidence of neodymium:YAG (Nd:YAG) laser damage. The majority of lenses (47.1%) had been explan ted because of persistent pigment deposits and chronic inflammation: D ecentration or IOL dislocation had occurred with 29.4% of lenses. All 17 patients had had Nd:YAG laser posterior capsulectomy, anterior surf ace polishing, or both; treatments ranged from one to 13 times. By bot h clinical and gross examination, the laser lesions appeared dark. Thi s was misinterpreted by some ophthalmologists as pigment deposits and some patients had additional Nd:YAG laser treatment, which increased t he severity of the laser damage. The mean depth of laser damage on the IOLs was 143 +/- 113.4 mum. It was between 51 and 175 mum in approxim ately 61.0% and deeper than 300 mum (maximum 660 mum) in 9.3%. We comp ared the explanted IOLs with silicone IOLs that were experimentally da maged using standard power levels from 0.3 to 3.0 mJ and different foc al areas. The appearance of the experimentally induced laser burns was equivalent to that on the explanted IOLs, especially the dark laser p its. Since the laser lesions may resemble pigment deposits on slitlamp examination, we recommend careful examination of patients prior to pl anned laser therapy.