A Rare Case of Acute Bilateral Endothelial Decompensation after Prophylactic Nd:YAG Laser Iridotomy Requiring Endothelial Keratoplasty

Yishay Weill; Adi Abulafia; David Smadja; Eduardo Roditi; Joel Hanhart; David Zadok

doi:10.5005/jp-journals-10078-1285

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A Rare Case of Acute Bilateral Endothelial Decompensation after Prophylactic Nd:YAG Laser Iridotomy Requiring Endothelial Keratoplasty

Yishay Weill, Adi Abulafia, David Smadja, Eduardo Roditi, Joel Hanhart, David Zadok

Keywords : Angle-closure glaucoma, Corneal edema, Corneal transplant, Laser iridotomy, Nd:YAG laser

Citation Information : Weill Y, Abulafia A, Smadja D, Roditi E, Hanhart J, Zadok D. A Rare Case of Acute Bilateral Endothelial Decompensation after Prophylactic Nd:YAG Laser Iridotomy Requiring Endothelial Keratoplasty. J Curr Glaucoma Pract 2020; 14 (3):109-111.

DOI: 10.5005/jp-journals-10078-1285

License: CC BY-NC 4.0

Published Online: 01-12-2020

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Abstract

Aim: To describe a case of acute bilateral endothelial decompensation following prophylactic Nd:YAG laser iridotomy (LI) for occludable angles. Background: Although regarded safe, LI can occasionally be a source of various ocular complications, including corneal endothelial damage. In the herein case, we describe the first case of acute bilateral endothelial decompensation after Nd:YAG LI. Case description: A 63-year-old man was referred for consultation due to visual acuity deterioration in both eyes 2 weeks after undergoing an uneventful prophylactic LI for occludable angles. On examination, bilateral corneal edema with Descemet's membrane folds was observed. Direct corneal damage from the laser beam was not seen. Specular microscopy failed to count endothelial density. Anterior-segment optical coherence tomography (OCT), ultrasound biomicroscopy, and ocular biometry were performed. The patient was referred for bilateral endothelial keratoplasty. Conclusion: Subacute endothelial dysfunction should be considered as a possible adverse event following Nd:YAG LI and patients should be advised accordingly. Clinical relevance: Surgeons should be aware of the potentially devastating complication of bilateral corneal decompensation following routine Nd:YAG LI, even in patients without preexisting corneal injury. Patients should be advised accordingly.

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Laser peripheral iridotomy in primary angle closure: A report by the American Academy of Ophthalmology. Ophthalmology. 2018;125(7):1110–1120. DOI: 10.1016/j.ophtha.2018.01.015.
Laser iridotomy and the corneal endothelium: A systemic review. Acta Ophthalmol 2014;92(7):604–616. DOI: 10.1111/aos.12367.
Effect of shear stress on attachment of corneal endothelial cells in association with corneal endothelial cell loss after laser iridotomy. Cornea. 2005;24(8 SUPPL.):55–58. DOI: 10.1097/01.ico.0000178735.27674.52.
A comparison of neodymium:YAG end argon laser iridotomies. Ophthalmology. 1984;91(9):1011–1016. DOI: 10.1016/S0161-6420(84)34199-9.
Neodymium-YAG laser iridotomy in the treatment and prevention of angle closure glaucoma. Arch Ophthalmol 1987;105(4):476–481. DOI: 10.1001/archopht.1987.01060040046029.
Iridectomy: A controlled study comparing argon and neodymium:YAG. Ophthalmology. 1986;93(1):20–24. DOI: 10.1016/S0161-6420(86)33787-4.
C. Fuchs’ endothelial dystrophy of the cornea. Surv Ophthalmol 1993;38(2):149–168. DOI: 10.1016/0039-6257(93)90099-S.
Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. Lancet. 2016;388(10052):1389–1397. DOI: 10.1016/S0140-6736(16)30956-4.
Has the EAGLE landed for the use of clear lens extraction in angle-closure glaucoma? And how should primary angle-closure suspects be treated? Eye. 2020;34(1):40–50. DOI: 10.1038/s41433-019-0634-5.
Comparing laser peripheral iridotomy to cataract extraction in narrow angle eyes using anterior segment optical coherence tomography. PLoS One 2016;11(9):1–16. DOI: 10.1371/journal.pone.0162283.

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