DELAYED INTRAOCULAR-LENS DISLOCATION AFTER NEODYMIUM-YAG CAPSULOTOMY

A poly(methyl methacrylate) PMMA) intraocular lens (IOL) dislocated in to the vitreous cavity in 2 patients after a neodymium:YAG (Nd:YAG) la ser posterior capsulotomy. In Case 1, the capsulotomy was performed 19 months after extracapsular cataract extraction (ECCE) and sulcus fixa tion of an IOL. Six months later the IOL dislocated posteriorly. In Ca se 2, ECCE with intracapsular IOL implantation was followed 4 years la ter by an Nd:YAG capsulotomy; 6 months later the IOL dislocated into t he vitreous cavity within the intact capsular bag. Different mechanism s were responsible for the dislocation: in Case 1, radial tearing of t he large capsular defect with IOL loosening and dislocation into the v itreous cavity; in Case 2, zonulysis and IOL dislocation within the in tact capsular bag. A neodymium:YAG capsulotomy may cause delayed IOL d islocation into the vitreous cavity.