Changes in intraocular lens position after neodymium:YAG capsulotomy

Abstract

Purpose To quantify changes in intraocular lens (IOL) position caused by neodymium:YAG (Nd:YAG) capsulotomy with 3 IOL styles. Setting Department of Ophthalmology, University of Vienna, Austria. Methods In a prospective study, anterior chamber depth (ACD) was measured by dual-beam partial coherence interferometry (PCI) in 32 pseudophakic eyes of 32 patients with posterior capsule opacification before and immediately after planned capsulotomy under mydriasis. Patients were divided into 3 groups with the following IOL styles: 1-piece poly(methyl methacrylate) (PMMA), 3-piece foldable, and plate haptic. Results The capsulotomy induced a backward IOL movement in all 32 eyes (mean 25 μm; range 9 to 55 μm). It was more pronounced in eyes with plate-haptic IOLs than in those with the other styles. Precision of ACD measurement by PCI was 4 μm. Changes in ACD correlated significantly with capsulotomy size but not with preoperative lens–capsule distance. Conclusion Capsulotomy caused a backward movement of the IOL, which was more pronounced with plate-haptic IOLs than with 1-piece PMMA and 3-piece foldable IOLs. Since the magnitude of IOL movement in this study population was small, a hyperopic shift in refraction after capsulotomy will usually be small and not clinically relevant.