Secondary ocular hypertension as a complication of posterior capsulotomy with Nd YAG laser in glaucoma suspect

Abstract

Posterior capsulotomy is indicated when the visual acuity is committed so that impacts the performance of ordinary activities or exploring the posterior pole structures as in the evaluation of the retina or optic nerve is difficult. As expected is not free of complications. There are reports of intraocular lens (IOL) pitting, elevation of intraocular pressure (IOP), cystoid macular edema, retinal detachment, endophthalmitis, iritis, vitritis, corneal edema and macular holes. Multidisciplinary immediate management of complications of posterior capsulotomy Nd-YAG laser prevents loss of corneal clarity and diminishes or prevents optic neuropathy secondary to increased IOP. We report the case of 70-year-oldwoman who presents 48 h after performing posterior capsulotomy with Nd-YAG laser with ocular pain and IOP of 34 mmHg. The inicial management included topical and oral ocular hypotensive and inflammatory therapy achieving normal eye pressure. During slit lamp biomicroscopy we found microguttae in corneal endothelium, vitreous in the anterior chamber, IOL dislocation, retinal pigment epithelial detachment (RPED), subretinal fluid and corneal edema. A vitrectomy was performed. We decided conservative treatment of the IOL, close monitoring and treatment of IOP and specular microscopy as part of a comprehensive treatment. Finally, subretinal fluid reabsorption is achieved although RPED remains with no changes, we achieve resolution of corneal and IOP is 12 mmHg without ocular antihypertensives. The final visual acuity is 20/40−2.

Posterior Capsule Opacification (PCO) Cases at Lamongan Eye Clinic: Two Years of Retrospective Data

“…Similarly, Ramon et al [20] reported that increased IOP al. [16] study an increase in IOP only occurred in 10% of cases.…”