Intraocular Lens Tattooing by Nd:YAG Laser : The Asia-Pacific Journal of Ophthalmology

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Intraocular Lens Tattooing by Nd:YAG Laser

Namdev, Vaibhav MBBS; Bhayana, Amber Amar MD; Prasad, Priyanka MD; Khokhar, Sudarshan Kumar MD

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Asia-Pacific Journal of Ophthalmology 12(2):p 267, March/April 2023. | DOI: 10.1097/APO.0000000000000499
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Neodymium:yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy1 is extensively used for clearing the visual axis in capsular opacification (Fig. 1). We report interesting microscopic images of intraocular lens (IOL) of a 58–year-old patient, who underwent trial of laser capsulotomy as treatment of her blurred vision post-cataract surgery, which was later explanted in view of IOL opacification.2 Best-corrected visual acuity improved from 3/60 preoperatively to 6/9 postoperatively after IOL exchange. The explanted IOL, when viewed under a light microscope, revealed interesting patterns as shown in binocular optical microscope. Most noticeable of which were a mitotic spindle and a flower. Shapes were formed depending on the proximity at which adjacent laser spots were fired, the power of the laser, and magnitude of defocus on the IOL. We would like to describe these patterns as “IOL tattoos.”

Figure 1:
Microscope photographs of explanted intraocular lens at (A) ×4, (B) ×10 and ×40 showing a mitosis spindle configuration like tattoo; (C) ×10 and ×40 showing a flower configuration like tattoo.


1. Karahan E, Er D, Kaynak S. An overview of nd:yag laser capsulotomy. Med Hypothesis Discov Innov Ophthalmol. 2014;3:45–50.
2. Khoramnia R, Yildirim TM, Labuz G, et al. Eintrübung von intraokularlinsen: erkenntnisse aus dem labor und der klinik [Opacification of intraocular lenses: laboratory and clinical findings]. Ophthalmologe. 2021;118:633–642. doi: 10.1007/s00347-020-01259-3.
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