Delayed dislocation of foldable plate-haptic silicone lenses after Nd:YAG laser anterior capsulotomy

PURPOSE: To report two eyes (two patients) that had plate haptic silicone intraocular lenses that dislocated 4 weeks after Nd:YAG laser anterior capsulotomy to relieve capsular contraction. METHODS: Case reports. The clinical records of two patients were reviewed. RESULTS: After uncomplicated phacoemulsification with implantation of plate haptic silicone lenses in the capsular bag, two eyes of two patients developed visually notable early contraction of the capsulorhexis. Three radial-relieving incisions approximately 1 mm long were made with a Nd:YAG laser in each eye to enlarge the capsulotomy. Although vision improved, both patients experienced sudden further reduction of vision after approximately 4 weeks. Upon examination of both patients, we noted an extension of an anterior radial capsulotomy incision peripherally, and the intraocular lenses had dislocated from the capsular bag into the ciliary sulcus. CONCLUSIONS: Tears may extend after radial-relieving incisions have been used to enlarge a contracted anterior capsulotomy, possibly because of continued capsular fibrosis. This may allow extrusion of a foldable intraocular lens from the capsular bag.