The Use Of Nd:Yag Laser For Retained Lens Fragments In The Anterior Chamber: A Case Series
Published 2023 - 41st Congress of the ESCRS
Reference: PP07.10 | Type: Free paper | DOI: 10.82333/7jhv-s459
Authors: Laura De Luca* 1 , Alessandro Meduri 1 , Pasquale Aragona 1
1Department of Biomedical and Dental Sciences and Morphofunctional Imaging SCHOOL OF OPHTHALMOLOGY ,Università degli studi di Messina ,Messina,Italy
Purpose
Retained lens fragments (LF) after cataract surgery are a rare but important complication that may lead to significant patient morbidity. In this multicenter study, we report the use of a YAG laser to fragment LF effectively in twelve patients.
Setting
Multicenter retrospective case series of yag laser fragmentation of LF in twelve patients at different clinics after cataract surgery with phacoemulsification and intraocular lens implant (IOL).
Methods
This is a multicentric retrospective case series of 12 patients, 6 eyes, from different clinics who underwent cataract surgery with phacoemulsification and were subsequently identified to have unilateral retention of lens fragments in the anterior segment. Exclusion criteria included trauma as the cause of dislocated lens fragments, dislocated IOL, corneal oedema, inflammatory cells in the anterior chamber, elevated IOP, history of uveitis. We performed Yag laser on day 10 day
Next-generation SLT/YAG laser (Optimis fusion, Ellex UltraQ, Ellex Tango) instruments were used at a voltage of 1.0 mV.
Results
Following cataract surgery and upon presentation with nuclear lens fragments, all patients had an uncorrected distance visual acuity (UDVA) of 20/20 or better. On a post-op day 1 following fragment removal, 5 out of 12 patients had a UDVA of 20/20 or better, while the other 7 a UDVA of 20/40. The mean IOP before cataract extraction (CE) was 16 mmHg (±2.5) with none higher than 21 mmHg. The average IOP measured post-fragment removal was 11 mmHg ±2. The majority of retained lens fragments were found in the inferior angle of the anterior chamber 75%, with the remaining located centrally. No patients developed cystoid macular oedema nor uveitis-like inflammatory responses following fragment removal.
Conclusions
Early Yag laser procedure is a good option to use for retained lens fragments in the anterior chamber after phacoemulsification, in order to reduce patient discomfort to re-enter surgery, to reduce costs of surgical re-intervention and to avoid possible inflammatory complications given by the retained fragments that may not be reabsorbed properly and may even present several years after primary surgery.