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A study of the probability of damage induced in two implant quality injection-molded diffractive intraocular lenses by a commercial Q-switched Nd:YAG laser is presented. The damage thresholds of the diffractive intraocular lenses (0.10 mJ at 10% probability, 0.24 mJ at 50% probability, and 0.90 mJ at 99% probability) did not differ significantly from those of other poly(methyl methacrylate) lenses manufactured with the same technology. These low values (compared to those of other lens types) suggest that care should be taken during laser capsulotomy in eyes implanted with refractive lenses, with special attention given to power losses at the target site due to diffraction effects.

The results of an extensive study of the probability of damage induced in implant quality intraocular lenses (IOLs) by a commercially available nanosecond Nd:YAG photodisruptor are presented. These results were compared with the morphology of damage seen on scanning electron microscopy. The differences in the shape of the damage probability curves derived for the different lens groups demonstrate that a single threshold value does not characterize the threshold for IOL damage. We suggest that a standard method using a clinical photodisruptor be used by all workers to derive these curves for all IOLs in clinical use. The clinical relevance of our findings is emphasized.

The damage that Nd:YAG laser radiation can cause to plastic (PMMA) IOLs during pseudophakic capsulotomy is well documented in the literature. This damage is the result of direct plasma action on the lens material. We report here another form of damage to PMMA IOLs which is more subtle and does not result from plasma action in the plastic. Even when the irradiance within the IOL is well below the threshold for optical breakdown, the PMMA can be damaged if irradiated by many laser pulses. This subthreshold damage is therefore cumulative. Its importance, likelihood of occurrence and ways to minimise this are considered.