Selective laser trabeculoplasty may compromise corneas with pigment on endothelium

Abstract

hyperostosis. 4 The direct correlation of hyperostosis relating to malignancy was not convincing, and the likely cause for bone growth would be inflammation related to ISOI. In cases of chronic refractory sinusitis, lytic and blastic forms of osteitis occur, and can result in hyperostosis of the nasal and paranasal bones, which was seen in 64% of patients with recurrent rhinosinusitis. 5 The chronic inflammation of ISOI likely caused a corresponding osteitis, an osteoblastic type in this case, producing hyperostosis and the bony changes seen in this case.Diagnosing ISOI is difficult and can further be complicated by the unusual finding of hyperostosis. Treatment of ISOI is controversial as studies using steroids, azathioprine, cyclosporine and radiation have been used with limited success. 1,2 With our patient's age and the systemic complications associated with his mesothelioma, treatment was deferred. This case highlights ISOI associated with hyperostosis, and it is important with this presentation that a concomitant work-up for occult malignancy is considered.

Same-Day Bilateral Glaucoma Laser Treatments in Ontario

“…13 Although most of these resolve with conservative treatment, there are cases of uncontrolled IOP requiring filtration surgery 14 and prolonged vision reduction secondary to corneal haze. [15][16][17] Physician reimbursement is also decreased for same-day bilateral procedures in Ontario with the second procedure reimbursed at 85% when performed on the same day.…”

Corneal Endothelial Abnormalities After Selective Laser Trabeculoplasty (SLT)

“…Hence, it is possible that the pigment or corneal endothelium could absorb some of the SLT energy and this can cause damage or burn to the corneal endothelial cells. 4 The pigment could have come from pigment deposition after laser peripheral iridotomy or intraocular surgery, pigment dispersion syndrome, or pigment associated with corneal guttatae. Hence, it is suggested that caution should be exercised when considering repeating SLT on patients with pigment on the corneal endothelium or reduced transparency of the corneal endothelium.…”

Polymegathism, Pleomorphism, and Endothelial Cell Count after Selective Laser Trabeculoplasty

“…It is of interest to note that the mean ECC showed a significant decline from the baseline in the eyes undergoing SLT, which was more pronounced in 1 week. Prior reports on the eyes with POAG suggest a transient decline in ECC following SLT, with eventual recovery at 1 month [8,14], as well analogues and beta-blockers. Assessments of IOP were performed at 9 am, 12 pm, and 5 pm (3 consecutive IOP measurements by Goldmann applanation tonometry, each was documented) and averaged to obtain the mean IOP.…”

“…For this reason, it is not recommended to prescribe corticosteroids in the postoperative period. However, there have been reports on pronounced inflammation of the anterior segment of an eye, accompanied by pain, fibrin deposition in the aqueous humor of the anterior chamber [7,8], and even by choroidal effusion [13,16]. There was a case of spontaneous bleeding in the anterior chamber (hyphema) that occurred during SLT [9].…”

“…Permanent corneal changes aft er SLT are extremely rare with only two reported cases [6]. Th ere were a few reports of post-SLT edema of the central corneal stroma, haze and subsequent corneal thinning, and scarring [7,8]. Much attention should be paid to the corneal endothelium.…”