Neodymium: Yttrium-Aluminum-Garnet Laser Anterior Hyaloidotomy to Treat Trapped Triamcinolone Acetonide Behind the Crystalline Lens After Intravitreal Injection

A 65-year-old male underwent intravitreal triamcinolone acetonide (IVTA) injection for treating a clinically significant macular edema (CSME) due to background diabetic retinopathy in his left eye. On the first postoperative day, visual acuity dropped from 20/80 to hand movements. Slit-lamp examination showed the drug between the posterior capsule of the lens and the anterior hyaloid face. Two weeks later, visual acuity and the milky fluid seemed unchanged. Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser anterior hyaloidotomy was performed. One week later, slit-lamp examination of the retrolental space revealed the complete disappearance of triamcinolone and intraocular pressure remained stable. After a follow-up period of 2 months, visual acuity increased to 20/50 with the lens remaining clear. Nd:YAG laser anterior hyaloidotomy is an effective, simple, useful and minimally invasive outpatient procedure in patients with persistent entrapment of triamcinolone behind the crystalline lens, allowing the drug to clear without trauma to the lens.