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

ABSTRACT

PURPOSE: To report a case of pupillary block and increased intraocular pressure caused by vitreous prolapse after NdYAG 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 NdYAG 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 NdYAG 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 NdYAG laser posterior capsulotomy in Korea. Physicians should be aware that pupillary block could be caused by prolapsed vitreous after NdYAG laser posterior capsulotomy and NdYAG laser iridotomy could be performed effectively in such cases.