Management Of Dysphotopsias Following Laser Peripheral Iridotomy: A Case Report
Published 2024 - 42nd Congress of the ESCRS
Reference: PO069 | Type: Case Report | DOI: 10.82333/f0fn-bw45
Authors: Rocío García Risco* 1 , Paula García Valentín 1 , Marc Tort Lacambra 1 , Cristina Pares Alfonso 1 , Olivia Pujol Carreras 1 , Marta Castany Aregall 1 , Jaime Rigó Quera 1 , Antoni Dou Saenz de Vizmanos 1 , Manuel Antonio Amilburu Pérez 1 , Laura Sánchez Vela 1
1OPHTALMOLOGY,VALL D'HEBRON UNIVERSITY HOSPITAL,BARCELONA,Spain
Purpose
This case report presents an unusual complication following laser peripheral iridotomy (LPI), characterized by persistent dysphotopsias. The aim of this report is to illustrate the occurrence of such a complication and explore various therapeutic alternatives for its management.
Setting
Ophtalmology Department, Hospital Universitario Vall d’Hebron, Barcelona (Cataluña), Spain
Report of case
We report a case of a 53-year-old male diagnosed with narrow bilateral angle who underwent bilateral laser peripheral iridotomy. Following the procedure, the patient experienced immediate dysphotopsias in the right eye, characterized by blurred vision, which significantly altered his quality of life.
His visual acuity remained unchanged at 0.7/0.9. Examination revealed a large laser iridotomy at 4 o’clock in the right eye and a smaller one at 5 o’clock in the left eye. Intraocular pressure (IOP) was measured at 14 mmHg in both eyes, and fundus examination was not affected.
After one month, the symptoms hadn’t improved. A conservative management with peripheral opaque contact lenses was introduced with complete response. Nevertheless, due to the economic impact and the risk of inadequate hygiene, the patient declined the lenses as the definitive treatment. Consequently, further investigation into therapeutic alternatives was pursued. A surgical intervention was then proposed, and iris suture repair of the iridotomy was performed in the right eye.
Several days post-surgery, the examination of the right eye showed transparent cornea, negative fluorescein staining, no signs of edema, and some cells in the anterior chamber. The suture was correctly positioned at 4 o'clock, and IOP was measured at 15 mmHg.
Symptomatic relief from dysphotopsias was achieved, and there were no signs of ocular inflammation during the follow-up. The patient expressed satisfaction with the outcomes.
Conclusion/Take home message
Laser peripheral iridotomy (LPI) is a frequent procedure utilized for the prevention or treatment of angle-closure glaucoma and other conditions characterized by the presence or potential development of relative pupillary block.
Even if LPI can be considered an easy to perform, safe, and comfortable procedure for the patient, there are several complications that should be considered.
Dysphotopsias are one uncommon complication that can occur and that may significantly impact quality of life. If they persist and conservative measures are ineffective, iris suture repair can provide a definitive intervention in resolving them.