Aqueous misdirection after Nd:YAG goniopuncture in deep sclerectomy treated with Nd:YAG irido-zonulo-hyaloidotomy

European Journal of Ophthalmology ◽

10.1177/11206721211019556 ◽

2021 ◽

pp. 112067212110195

Author(s):

Faisal A Almobarak

Keyword(s):

Anterior Chamber ◽

Nd:Yag Laser ◽

Medical Management ◽

Deep Sclerectomy ◽

Pseudoexfoliation Glaucoma ◽

Case Presentation ◽

Yag Laser ◽

Laser Iridotomy ◽

Aqueous Misdirection

Background: To report a case of aqueous misdirection after goniopuncture in deep sclerectomy treated with Nd:YAG laser irido-zonulo-hyaloidotomy. Case presentation: About 72 years old patient with pseudoexfoliation glaucoma who underwent deep sclerectomy, developed aqueous misdirection after Nd:YAG laser goniopuncture. Medical management failed and subsequent peripheral Yag laser iridotomy to expose the zonules coupled with laser zonulo-hyaloidotomy was done and an instant gush of aqueous and vitreous substance prolapse through the iridotomy was noticed. Later, the anterior chamber was deep and the pressure was controlled. Conclusions: Aqueous misdirection can occur after Nd:YAG laser goniopuncture. Nd:YAG laser irido-zonulo-hyaloidotomy can be effective in breaking the attack.

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Fractured Anterior Chamber Intraocular Lens (ACIOL) Complicating Nd: YAG Laser for Peripheral Iridotomy

The Open Ophthalmology Journal ◽

10.2174/1874364101408010001 ◽

2014 ◽

Vol 8 (1) ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

Edgard Farah ◽

Chryssanthi Koutsandrea ◽

Ioannis Papaefthimiou ◽

Dimitris Papaconstantinou ◽

Ilias Georgalas

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

Vitreous Hemorrhage ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Single Shot ◽

Yag Laser ◽

Pupillary Block ◽

Laser Iridotomy ◽

Peripheral Iridotomy

Laser peripheral iridotomy is the procedure of choice for the treatment of angle-closure glaucoma caused by relative or absolute pupillary block. Nd: YAG laser iridotomy has been reported to have several complications such as Iris bleeding, hyphema, transient IOP elevation, intraocular inflammation, choroidal, retinal detachment and vitreous hemorrhage. We report a case of a 74 year old lady on anticoagulant treatment who developed pupillary block and angle closure glaucoma after cataract surgery and anterior chamber intraocular lens (ACIOL) insertion complicated with intraoperative bleeding. The patient was treated with Nd: YAG laser iridotomy , however, the ACIOL was inadvertently fractured after a single shot of laser and it had to be replaced. Although the incidence is rare. Ophthalmologists and Opticians should be aware that an ACIOL may be fractured even after a single Nd:YAG laser shot and avoid to perform it close to the ACIOL. Pretreatment counseling should include this rare complication.

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Pars plana vitrectomy combined with irido-zonulo-hyaloidectomy for aqueous misdirection

European Journal of Ophthalmology ◽

10.1177/1120672119872056 ◽

2019 ◽

Vol 30 (2) ◽

pp. 396-398

Author(s):

Shriji Patel

Keyword(s):

Intraocular Pressure ◽

Anterior Chamber ◽

Study Design ◽

Medical Management ◽

Pars Plana Vitrectomy ◽

Pars Plana ◽

Design Materials ◽

Aggressive Medical Management ◽

Aqueous Misdirection

Introduction: To review the indications and necessary steps for successful irido-zonulo-hyaloidectomy in persistent aqueous misdirection. Study design/materials and methods: A 60-year-old woman was referred for persistent aqueous misdirection despite aggressive medical management. Her intraocular pressure would elevate with discontinuation of cycloplegics and her lens shifted anteriorly. She underwent standard 25g pars plana vitrectomy with irido-zonulo-hyaloidectomy. Results: The aqueous misdirection resolved with successful creation of the irido-zonulo-hyaloidectomy with noticeable deepening of the anterior chamber immediately. Vision improved to 20/30 and intraocular pressure was controlled without cycloplegics or ocular hypotensives. Conclusion: In persistent cases of aqueous misdirection unresponsive to medical management, irido-zonulo-hyaloidectomy is a useful adjunct to pars plana vitrectomy in ensuring resolution of the misdirection.

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