Rotation of a toric intraocular lens from neodymium:YAG laser posterior capsulotomy

A 77-year-old man had cataract surgery in the left eye in March 2017. A toric intraocular lens (IOL) was implanted because of astigmatism. The postoperative meridian of the IOL was located nearly exactly in the planned meridian, which was controlled 1 week later with ray-tracing aberrometry (iTrace) and the smartphone application Axis Assistant. The referring ophthalmologist proceeded directly with a neodymium:YAG (Nd:YAG) laser posterior capsulotomy in his own office, after which the meridian of the implanted toric IOL was rotated more than 115 degrees. The rotation of the IOL was likely the result of a very early Nd:YAG treatment. Therefore, when a toric IOL is implanted it is important to wait at least 3 months after cataract surgery before proceeding with Nd:YAG to ensure complete rotational stability of the IOL.