The role of nd:yag laser anterior hyaloidotomy to treat an entrapment of intravitreal triamcinolone in the beger´s space

Abstract Purpose To describe a persistent entrapment of triamcinolone acetonide behind the crystalline lens (Berger´s space), a rare complication of intravitreal triamcinolone acetonide (IVTA) injection, and its successful drainage using a Nd:YAG laser anterior hyaloidotomy. Methods A case report providing a new indication of Nd:YAG laser, performing an anterior hyaloidotomy to release triamcinolone acetonide entrapped between the crystalline lens and the anterior hyaloids membrane following an IVTA injection. Results A 66‐year‐old male suffering from diffuse diabetic macular edema in his left eye was treated with an IVTA injection. The following day he complained from sudden loss of vision. Visual acuity dropped from 20/80 to "hand motion", and biomicroscopy showed a drug entrapment in the Berger´space. After a couple of weeks of observation treatment, Nd:YAG laser anterior hyaloidotomy was performed. One week later, slit lamp examination of the retrolental space revealed the complete disappearance of triamcinolone, visual acuity recovered to 20/50, remaining the means transparent. Conclusion We describe a minimally invasive, quick, simple and effective outpatient procedure to release rests of triamcinolone acetonide entrapped behind the crystalline lens. This indication of Nd:YAG laser has never been described before.