Neodymium: YAG membranectomy for pupillary membranes on posterior chamber intraocular lenses.
OBJECTIVE
To evaluate the effectiveness of neodymium: YAG laser for the removal of membranes from the anterior surface of intraocular lenses.


METHODS
Seven patients had reduced vision due to a membrane on the anterior surface of a posterior chamber intraocular lens (PC IOL). Six of the membranes developed after extracapsular cataract surgery and PC IOL combined with trabeculectomy and one after pars plana vitrectomy. Six of the membranes developed in the early postoperative period in association with a fibrinous reaction of the anterior chamber. One formed 7 months after surgery in an eye with iris capture behind the IOL. The membranes persisted despite intensive topical steroid therapy. A neodymium: YAG (Nd:YAG) laser was used to remove the membranes from the anterior of the IOL in all the seven cases.


RESULTS
The Nd:YAG laser effectively severed the peripheral connections of the membranes to the iris and lens, creating a clear central zone within the visual axis. The settings were fundamental mode, 1.2-to 3.1-mJ energy per shot and 48.3 +/- 20.1 single pulses. Vision improved significantly in six patients, whereas elevated intraocular pressure was observed in one patient.


CONCLUSIONS
Postoperative pupillary membranes may be successfully lysed with use of the Nd:YAG laser.
Gandham
S B
SB
William and Anna Goldberg Glaucoma Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia.
Brown
R H
RH
Katz
L J
LJ
Lynch
M G
MG
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy; D007910:Lenses, Intraocular; D008297:Male; D008566:Membranes / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011680:Pupil; D014130:Trabeculectomy / Q000009:adverse effects; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects