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Abstract #6569 Published in IGR 3-2
Pupillary distortion and staphyloma following transscleral contact diode laser cyclophotocoagulation: a clinicopathological study of three patients
Bhola RM; Prasad S; McCormick AG; Rennie IG; Talbot JF; Parsons MAEye 2001; 15: 453-457
PURPOSE: To search for the cause of scleral thinning and pupillary distortion following transscleral contact diode laser cyclophotocoagulation (TCDLC). METHODS: The authors reviewed the records of three patients in whom there were complications of scleral thinning and pupillary distortion following TCDLC. One of the eyes was later enucleated, and the histopathological findings are presented. Using the histopathological features in this patient, the authors discuss the possible pathogenesis of the scleral thinning and pupillary distortion. RESULTS: Case 1 is a 46-year-old white female who, following TCDLC in an area of clinically normal sclera, developed a staphyloma. Case 2 is a 52-year-old white female who, following TCDLC in an area of scarred sclera, developed mild thinning. Case 3 is an 85-year-old white male who, following TCDLC, developed pupillary distortion, and gonioscopy revealed damage to the peripheral iris. Histological examination of case 1 revealed the staphyloma covered by a thin layer of conjunctival epithelium, collagen and vitreous condensation. Cicatrical ciliary body contraction causing distortion of the pupil and lens was also observed. CONCLUSIONS: Therapeutic TCDLC can produce scarring of the iris root, anterior chamber angle, draining structures and ciliary body, and may result in pupillary distortion. Pre-existing scleral scars may predispose to scleral damage following TCDLC. A simple strategy to avoid this complication of TCDLC is discussed.
Mr. R.M. Bhola, Ophthalmology Department, A Floor, Royal Hallamshire Hospital, Sheffield S10 2JF, UK. ronmb2@hotmail.com
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
