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Abstract #90327 Published in IGR 21-3
Use of laser iridoplasty in iris incarceration of a glaucoma drainage device
Islam Y; Blake CRAmerican journal of ophthalmology case reports 2020; 20: 100910
PURPOSE: To describe the use of laser iridoplasty to release iris incarceration occluding a glaucoma drainage device. OBSERVATIONS: A 46-year-old male with uncontrolled type 1 diabetes mellitus presented with neovascular glaucoma and subsequently had a glaucoma drainage device implanted for control of intraocular pressure. One month post-operatively, he presented with a significantly elevated intraocular pressure, thought to be due to poor drainage from iris incarceration in the device. He had recently developed a vitreous hemorrhage and hyphema, and he had florid neovascularization of the iris, thus raising concern that traditional neodymium:yttrium-aluminum-garnet (Nd:YAG) iridotomy would promote re-formation of the hyphema. Thus, a diode solid-state laser iridoplasty was performed around the site of incarceration, resulting in successful release of the iris from the device without hyphema formation. CONCLUSIONS AND IMPORTANCE: Glaucoma drainage devices are effective tools to help control intraocular pressure. However, they risk post-operative complications, such as iris incarceration within the device, that prevents them from functioning properly. In such cases, Nd:YAG laser iridotomy is often used around the site of incarceration, thus releasing it from the device. In this case report, we describe how diode solid-state laser can be used to release the iris incarceration via iridoplasty. Such iridoplasty may result in a decreased likelihood of hyphema formation as compared to Nd:YAG iridotomy, so this provides a superior alternative in patients with a propensity for developing a hyphema, such as in patients with iris neovascularization.
University of Florida, Department of Ophthalmology, 1600 SW Archer Road, Gainesville, FL, 32610, USA.
Full articleClassification:
12.3 Laser iridoplasty (Part of: 12 Surgical treatment)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)