title: Fracture and dislocation of a glass intraocular lens optic as a complication of neodymium:YAG laser posterior capsulotomy: Case report and literature review.
abstract: An 83-year-old man presented with a 1-year history of blurry vision in his left eye. Bilateral cataract surgery and ciliary sulcus posterior chamber intraocular lens (IOL) implantation had been performed 11 years earlier. The corrected distance visual acuity (CDVA) was 20/60 in the left eye. Slitlamp examination revealed moderate posterior capsule opacification. Neodymium:YAG laser posterior capsulotomy was performed and complicated by IOL fracture and immediate dislocation of optic fragments into the anterior chamber. An IOL exchange was performed, and the damaged IOL was removed in 7 pieces. A 3-piece acrylic IOL was suture fixated to the posterior iris. Pathologic analysis showed that the damaged IOL was made of glass supported by a polyimide frame. Twelve months after the IOL exchange, the CDVA was 20/60.
  
  
  BACKGROUND
  Dr. Ahmed is a consultant to Alcon Laboratories, Inc., Abbott Medical Optics, Inc., and Bausch & Lomb. Dr. Mamalis is a consultant to Anew Optics, Inc., and Medennium, Inc. No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA.
authors.forename: Harmanjit
authors.initials: H
authors.lastname: Singh
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Kwan
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA.
authors.forename: Diamond
authors.initials: D
authors.lastname: Tam
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA.
authors.forename: Nick
authors.initials: N
authors.lastname: Mamalis
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: MacLean
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA. Electronic address: ikeahmed@mac.com.
authors.forename: Iqbal Ike K
authors.initials: II
authors.lastname: Ahmed
mesh_terms: D000369:Aged, 80 and over; D060437:Artificial Lens Implant Migration / Q000209:etiology*; D058442:Capsule Opacification / Q000601:surgery; D005898:Glass; D006801:Humans; D053844:Lasers, Solid-State / Q000009:adverse effects*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D064727:Posterior Capsulotomy / Q000009:adverse effects*; D011475:Prosthesis Failure / Q000209:etiology*; D012086:Reoperation; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity