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July 1987

Neodymium-YAG Laser Zonulotomy

Arch Ophthalmol. 1987;105(7):892-894. doi:10.1001/archopht.1987.01060070028011

To the Editor.  —Refractive errors in patients with dislocated crystalline lenses can be managed either by optical correction or surgically.1In minimal lens dislocation, spectacles often correct an induced cylinder from lens tilting or edge effect. With complete dislocation, aphakic contact lenses are appropriate. However, in intermediate degrees of dislocation, the options are partially occlusive contact lenses, which may reduce the edge effect, pupilloplasty, and lens extraction.We treated a patient who had intermediate lens dislocation with neodymium-YAG zonulotomy, which increased the degree of dislocation and permitted the use of the aphakic field.

Report of a Case.  —A 39-year-old woman had an 18-year history of idiopathic inferior dislocation of her crystalline lens (Fig 1, left). For 11 years she had successfully used a rigid contact lens until troubled by glare, reduced visual acuity, monocular diplopia, and poor contrast due to refraction at the phakic-aphakic interface.She was fitted