Anterior Endolaser for Optic-Haptic Junction Tilt

Drs. Allison Chen and Alexander Bui describe the case of a 63-year-old patient found to have a tilted IOL on postoperative day 1 after a routine combined pars plana vitrectomy + Yamane procedure with a CT Lucia lens. Loss of structural integrity of the IOL at the optic-haptic junction has been noted in recent cases of IOL tilt. Inspired by Drs. Drew Scoles and Jeremy Wolfe's Laser to the Rescue video, we performed intraoperative argon laser (200–250 mW, 0.50 sec) at the optic-haptic junction to lock in and stabilize the IOL in a planar position. Our experience demonstrates that IOL tilt due to rotation in the optic-haptic junction can be addressed intraoperatively by the anterior segment surgeon and that argon laser should be made accessible in the operating room to address: 1) any evidence of immediate haptic rotation upon IOL insertion; 2) potential preemptive treatment prior to insertion of the IOL (see Maxwell Stem et al., Laser Lock Technique for Zeiss IOL Stabilization); or 3) postoperative IOL tilt, as in our patient.

Financial Disclosures: Dr. Allison Chen discloses no relevant financial relationships. Dr. Alexander Bui discloses no relevant financial relationships.