Use of the neodymium YAG laser following posterior chamber lens implantation

The authors report on the neodymium-YAG laser used after extracapsular cataract extraction with the implantation of a posterior chamber lens in 1726 patients. The most common indication was capsular fibrosis necessitating posterior capsulotomy. The alternative to the YAG laser would be a bulbus-opening procedure via pars plana using a Sato knife. The advantage of the YAG laser in comparison with capsulotomy with a Sato knife is that there is no danger of intraocular infection or bleeding (which may result from tension on the fibers with the first method). A disadvantage of the YAG laser method is a possible transitory increase in intraocular pressure and an endothelial cell loss. In 1726 cases with posterior chamber lenses 45 capsulotomies using the YAG laser were necessary. A further indication for the YAG laser are posterior chamber lenses decentered by capsular fibrosis (3 cases). A third indication is chorepraxia after posterior chamber lens implantation. In three cases with posterior chamber lenses a flattening of the pupil occurred because remnants of the anterior capsule had shifted into the anterior chamber. In two cases a pupil became decentered for no apparent reason. In these cases YAG laser therapy is indicated. In at least three cases pupillary membranes were cut with the YAG laser. The authors treated their patients with the Lasertec model 135 YAG laser (Q-switched mode).