Traumatic Cataract Formation With Posterior Capsule Defects After Yag Laser Vitreolysis For Symptomatic Floaters

To report two secondary cataract cases associated with posterior capsular defects caused by
Nd:YAG laser vitreolysis for symptomatic vitreous floaters.

Case report

Two patients underwent Nd:YAG laser vitreolysis for symptomatic floaters. Both
patients had blurred vision in one of the treated eyes after YAG laser vitreolysis. A
secondary cataract with posterior capsular defects was noted using a slit-lamp
biomicroscope. These two patients underwent trans pars plana vitrectomy,
phacoemulsification, intraocular lens implantation, and focal retinal
photocoagulation by the same surgeon. Both eyes were found to have a posterior
capsule rupture with lens materials in the vitreous intraoperatively. A three-piece
acrylic intraocular lens was placed in the sulcus with optic capture in one of the
patients. For the other patient, a single-piece acrylic intraocular lens was placed in
the bag. The best-corrected visual acuity was 20/25 in the six-month follow-up and
20/20 in the one-month follow-up, respectively.

Traumatic cataract formation with posterior capsule defect is a potential
complication of Nd:YAG laser vitreolysis for symptomatic floaters. When managing
such complex cataracts, clinicians should be aware of the potential for posterior lens
capsule rupture during surgery and consider the necessity of performing a combined
vitrectomy.