Nd:YAG Capsulotomy Induced Pupillary Block Glaucoma- A Rare Case Report

Abstract

A 70-year-old female reported with complaints of defective vision in both eyes. Ophthalmological examination of both eyes revealed well-centred Posterior Chamber Intraocular Lens (PCIOL), thin membranous Posterior Capsular Opacification (PCO) with no signs of inflammation, myopic fundus and normal Intraocular Pressure (IOP). She had history of uneventful cataract surgery in both eyes four years back and was on treatment for diabetes mellitus and chronic obstructive pulmonary disease. PCO was managed with Nd: YAG capsulotomy in both eyes. After ten hours, patient reported back with severe headache, right-sided periorbital pain and profound diminution of vision. Examination revealed corneal oedema, shallow Anterior Chamber (AC) and raised IOP in her right eye. Patient was admitted and treated with parenteral and local IOP lowering agents and cycloplegic agents. Once the IOP was lowered and cornea cleared, slit lamp examination revealed vitreous blocking the pupil resulting in secondary angle closure which was confirmed by Anterior Segment Optical Coherence Tomography (AS-OCT). Nd:YAG LASER peripheral iridotomy was done to relieve the pupillary block. This is presented as a rare case of pupillary block following Nd:YAG capsulotomy in the presence of well-centred PCIOL.

Keywords

• intraocular pressure
• posterior chamber intraocular lens
• pupillary block