J Korean Ophthalmol Soc.  2013 May;54(5):834-837. 10.3341/jkos.2013.54.5.834.

A Case of Pupillary Block and Increased Intraocular Pressure after Nd:YAG Laser Posterior Capsulotomy

• Kang KM
• Kim JJ
• Lee JH
• Shin JP

• KMID: 2217056
• DOI: http://doi.org/10.3341/jkos.2013.54.5.834

Abstract

PURPOSE
To report a case of pupillary block and increased intraocular pressure caused by vitreous prolapse after Nd:YAG laser posterior capsulotomy.
CASE SUMMARY
A 70-year-old male visited the hospital for decreasing visual acuity and ocular pain in the left eye. Two days earlier, he had undergone Nd:YAG laser posterior capsulotomy in the left eye. Best corrected visual acuity (BCVA) was 0.63 in the right eye and FC 60 cm in the left eye. Intraocular pressure (IOP) was 14 mm Hg in the right eye and 64 mm Hg in the left eye. Slit-lamp examination revealed diffuse corneal stromal edema and iris bombe with vitreous prolapse in the anterior chamber. Gonioscopy confirmed a closed angle. Pupillary block and increased intraocular pressure were diagnosed. A Nd:YAG laser iridotomy was performed. Three days after the iridotomy, BCVA was 0.2 and IOP was 11 mm Hg in the treated eye. Slit-lamp examination revealed reduced vitreous prolapse in the anterior chamber.
CONCLUSIONS
This is the first report of pupillary block and increased IOP caused by vitreous prolapse after Nd:YAG laser posterior capsulotomy in Korea. Physicians should be aware that pupillary block could be caused by prolapsed vitreous after Nd:YAG laser posterior capsulotomy and Nd:YAG laser iridotomy could be performed effectively in such cases.

Keyword

Nd:YAG capsulotomy; Pupillary block; Vitreous prolapse

MeSH Terms

Anterior Chamber
Bombs
Edema
Eye
Gonioscopy
Humans
Intraocular Pressure
Iris
Korea
Male
Prolapse
Visual Acuity

Figure

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  Figure 1. (A, C) At the initial visit, slit-lamp photography shows prolapsed vitreous in the anterior chamber (white arrows) and Pentacam Scheimpflug image shows vitreous in the anterior chamber with endothelial touch (white ar-row heads). (B, D) Three days after the iridotomy, slit-lamp photography shows reduced vitreous prolapse in the an-terior chamber (white arrows) and Pentacam Scheimpflug image shows vitreous in the anterior chamber with clear space between the corneal endothelium and prolapsed vitreous (white arrow heads).

Reference

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