Delayed intraocular lens dislocation after neodymium:YAG capsulotomy.

A poly(methyl methacrylate)(PMMA) intraocular lens (IOL) dislocated into the vitreous cavity in 2 patients after a neodymium:YAG (Nd:YAG) laser posterior capsulotomy. In Case 1, the capsulotomy was performed 19 months after extracapsular cataract extraction (ECCE) and sulcus fixation of an IOL. Six months later the IOL dislocated posteriorly. In Case 2, ECCE with intracapsular IOL implantation was followed 4 years later by an Nd:YAG capsulotomy; 6 months later the IOL dislocated into the vitreous cavity within the intact capsular bag. Different mechanisms were responsible for the dislocation: in case 1, radial tearing of the large capsular defect with IOL loosening and dislocation into the vitreous cavity; in Case 2, zonulysis and IOL dislocation within the intact capsular bag. A neodymium:YAG capsulotomy may cause delayed IOL dislocation into the vitreous cavity.