Biconvex intraocular lenses and Nd:YAG capsulotomy: experimental comparison of surface damage with different poly(methyl methacrylate) formulations.

Biconvex posterior chamber lenses have optical advantages and decrease the risk of capsular opacification, but they are more likely to be pitted during ND:YAG capsulotomy because of apposition of the lens to the capsule. This study reports the likelihood of surface damage to different formulations of poly(methyl methacrylate) at the energy levels required to open posterior capsules. Molded lenses are more easily damaged than higher molecular weight lathe-cut materials (P less than .01), as expected. However, by keeping energy output low, even injection-molded lenses showed minimal damage, with mean pit size 39 +/- 39 microns at 1 mJ. By using a converging contact lens, low power, and keeping the focus behind the capsule, damage to all materials tested should be clinically insignificant.