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Editors Selection IGR 14-4

Clinical Forms of Glaucoma: Secondary glaucoma

Comment by Malik Kahook on:

59338 Refractory open-angle glaucoma after neodymium-yttrium-aluminum-garnet laser lysis of vitreous floaters, Cowan LA; Khine KT; Chopra V et al., American Journal of Ophthalmology, 2015; 159: 138-143

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Nd:YAG vitreolysis for floaters is a non-FDA approved treatment modality that has been linked with serious adverse events such as cataract formation and retinal detachment.

Nd:YAG vitreolysis for floaters is a non-FDA approved treatment modality

While cases of transient elevation in intraocular pressure (IOP) have been reported after this procedure, the incidence of chronic elevation in pressure is not known. Cowan and colleagues report two cases (three eyes) of significant IOP elevation after Nd:YAG vitreolysis that required escalation of medical/laser therapy and, in two eyes, invasive surgery. The pathophysiology of the IOP elevation is not clear and would be difficult to surmise from the information provided in this report. Furthermore, the small number of eyes included in this report, and retrospective nature of the data collection, makes it difficult to generalize the findings to all patients undergoing this procedure. Nevertheless, it is important to consider this potential complication when counseling patients who are considering this treatment modality for vitreous floaters.

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