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

Min Kang Kyoung; Jin Kim Jong; Hun Lee Jun; Pil Shin Jae

doi:10.3341/jkos.2013.54.5.834

Journal List > J Korean Ophthalmol Soc > v.54(5) > 1009691

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Kyoung, Jong, Jun, and Jae: A Case of Pupillary Block and Increased Intraocular Pressure after Nd:YAG Laser Posterior Capsulotomy

Original Article

J Korean Ophthalmol Soc 2013;54(5):834-837.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.5.834

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

Min Kang Kyoung, MD, Jin Kim Jong, MD, Hun Lee Jun, MD, Pil Shin Jae, MD, PhD

¹Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea

Address reprint requests to Jae Pil Shin, MD, PhD Department of Ophthalmology, Kyungpook National University Hospital #130 Dongdeok-ro, Jung-gu, Daegu 700-721, Korea Tel: 82-53-200-5817, Fax: 82-53-426-6552, E-mail: jps11@hanmail.net

Received 31 August 201215 November 2012 Accepted 5 March 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 af-ter Nd:YAG laser posterior capsulotomy and Nd:YAG laser iridotomy could be performed effectively in such cases.

Keywords: Nd, YAG capsulotomy, Pupillary block, Vitreous prolapse

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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).

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