Intraocular lens subluxation during Nd:YAG capsulotomy on an eye with primary congenital glaucoma

Abstract

Intraocular lens (IOL) dislocation is an uncommon complication of Nd:YAG laser capsulotomy. This report presents the case of primary congenital glaucoma of both eyes of a young girl with glaucoma who presented with bilateral increased blurring of vision secondary to posterior capsular opacification. The opacification developed within a few years after sequential glaucoma drainage device implantation, trabeculectomy, and cataract surgery for both eyes. Laser shots were administered on the right eye from the 8 o'clock to 4 o'clock positions behind the lens optic in a circular pattern. The procedure was aborted when the IOL subluxated inferiorly. Ultrasound biomicrocopy results showed undetectable inferior zonules on the right eye and zonular stretching on the left eye. This case demonstrates an increased risk for complication when performing Nd:YAG laser on eyes with congenital glaucoma. This risk should be taken into consideration before offering this simple procedure in this subset of patients.