Fractured Anterior Chamber Intraocular Lens (ACIOL) Complicating Nd: YAG Laser for Peripheral Iridotomy

Edgard Farah 1, Chryssanthi Koutsandrea 2, Ioannis Papaefthimiou 1, Dimitris Papaconstantinou 2, Ilias Georgalas*, 2
1 Department of Ophthalmology, “G. Gennimatas” Hospital of Athens, NHS, Greece
2 Department of Ophthalmology, “G. Gennimatas” Hospital of Athens, University of Athens, Greece

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© Farah et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Consultant Vitreoretinal Surgeon, 59 Chrysanthemon str, 15452 Athens, Greece; Tel/Fax: +30 2107768000; E-mail:


Laser peripheral iridotomy is the procedure of choice for the treatment of angle-closure glaucoma caused by relative or absolute pupillary block. Nd: YAG laser iridotomy has been reported to have several complications such as Iris bleeding, hyphema, transient IOP elevation, intraocular inflammation, choroidal, retinal detachment and vitreous hemorrhage.

We report a case of a 74 year old lady on anticoagulant treatment who developed pupillary block and angle closure glaucoma after cataract surgery and anterior chamber intraocular lens (ACIOL) insertion complicated with intraoperative bleeding. The patient was treated with Nd: YAG laser iridotomy , however, the ACIOL was inadvertently fractured after a single shot of laser and it had to be replaced. Although the incidence is rare. Ophthalmologists and Opticians should be aware that an ACIOL may be fractured even after a single Nd:YAG laser shot and avoid to perform it close to the ACIOL. Pretreatment counseling should include this rare complication.

Keywords: Laser peripheral iridotomy, Anterior Chamber Intraocular Lens, Nd, Yag Laser, Complications.