DR ISHA CHATURVEDI

Prof. MAJ GEN (MRS.) SAGARIKA PATYAL, PROF. MAJ GEN (MRS.) SAGARIKA PATYAL

Abstract

Acute elevation of intraocular pressure (IOP) is a common occurrence after vitreoretinal (VR) surgery due to secondary angle closure from inflammatory pupillary block, leading to iris bombe formation. Although Nd-YAG laser iridotomy is the standard treatment, there is a high failure rate due to continuous inflammation. Management of IOP is often refractory to conventional therapy and invasive procedures like paracentesis and glaucoma surgery have inherent risks. We describe a novel technique in 3 cases who presented with iris bombe and high IOPs within 1 week of VR surgery. IOP remained high despite medical treatment and laser peripheral iridotomies failed within a week. We first re-opened the previous iridotomies using Nd-YAG laser and then performed laser synechiolysis at the pupillary border. There was iris flattening in all 3 cases and IOP normalized. The novelty of this study is that all cases had iris bombe post vitrectomy, which resolved with a new, non-invasive laser technique.