Monocular diplopia after neodymium: YAG laser capsulotomy.

Purpose: To present an unusual complication of posterior capsulotomy such as monocular diplopia and to discuss the importance of capsulotomy size.

Case Report: A 57-year old man came to our clinic complaining of horizontal monocular diplopia in his right eye for the past 3 days. The patient had undergone a Nd:YAG capsulotomy in this eye 3 weeks before. Slit-lamp biomicroscopy under pupil dilation revealed a small capsulotomy and a considerable Elschnig pearl as the presumable cause of the diplopia. The rest of the examination was completely normal.

Results: After repeat Nd:YAG capsulotomy treatment, the diplopia disappeared.

Conclusion: Capsulotomy size is a significant factor to consider when treating a posterior capsular opacification. A capsulotomy that is larger than the pupil diameter under scotopic conditions may avoid disturbances of vision such as monocular diplopia.