A Disastrous Complication Of Yag Laser Capsulotomy

Published 2022 - 40th Congress of the ESCRS

Reference: PO059 | Type: Case report | DOI: 10.82333/hp9h-sv02

Authors: Riddhi Dipak Thaker* ¹ , Ahmed Bardan ² , Bassma Al-Baioumy ³ , Ahmed Souka ⁴

¹Department of Ophthalmology,Birmingham Midlands Eye centre,Biringham,United Kingdom, ²Ophthalmology,Leeds teaching Hospitals, NHS Trust, England,Leeds,United Kingdom, ³Department of Ophthalmology,Faculty of Medicine, University of Alexandria,Alexandria,Egypt, ⁴Department of Ophthalmology,University of Alexandria,Alexandria,Egypt

To raise awareness of a complication related to YAG laser in a patient with an ICL lens.

Ophthalmology clinic review

A 41-year-old patient presented with unilateral, painful eye following a YAG laser capsulotomy. This was carried out by a local ophthalmologist when she presented with hazy vision in the right eye. It was thought her symptoms were from intraocular lens (IOL) related posterior capsular opacification.

When presenting back to the original Eye surgeon, her visual acuity in this eye had dropped from 6/12 to HM. Her eye was slightly inflamed with raised intraocular pressure and a white intumescent cataract was seen underneath a -12-Implantable collamer lens (ICL). This was implanted 6 and half years back. It appeared that her crystalline lens was breached by the YAG laser, causing an acute inflammatory response. The decision was made to remove the ICL and cataract immediately. During the operation, it was noticed that the posterior capsule was breached and a pars plana vitrectomy had to be performed to remove the dropped lens fragments. The patient’s corrected VA reached 6/12 one-month post-operatively and IOP was controlled with topical anti-glaucoma drops.

From this case we learn that it is paramount to take an appropriate past ocular history as well as to dilate the patient prior to listing for YAG laser capsulotomy. ICLs have recently gained popularity due to the remarkable effect on unaided vision and substantial improvement in quality of life. Hence, raising awareness of such complications is vital. The eye does not see what the mind does not know; therefore introducing a standardised training programme is of paramount importance. Especially when there is a growing trend to transfer the YAG laser burden onto the community opticians.