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Abstract #26701 Published in IGR 12-3
Pupillary block after laser photocoagulation for retinopathy of prematurity
Sawchyn AK; McGregor ML; Fellows RRJournal of AAPOS 2009; 13: 27-28
Introduction: Pupillary block is a rare but vision-threatening complication after laser photocoagulation for retinopathy of prematurity (ROP). Methods: A retrospective review of pupillary block following laser treatment from January 1998 to July 2008 was conducted. Data regarding birth weight and gestational age, postoperative regimens (use of cycloplegics and steroids), presenting signs suggestive of pupillary block, and time interval to the development of these signs were recorded. Results: Eleven eyes of 6 patients developed angle closure after laser photocoagulation. Presenting signs suggestive of pupillary block included synechiae (10 eyes), shallow anterior chamber (9 eyes), intraocular pressure (IOP) elevation (4 eyes), cataract (3 eyes), poor pharmacologic dilation (3 eyes), cloudy cornea (2 eyes), and iris bombe (1 eye). Treatments included peripheral iridectomy, lensectomy, lysis of posterior synechiae, and goniolysis. IOP and visual outcomes after intervention were evaluated for each of these patients. There was a correlation between early detection and favorable outcome. Discussion: There is no standard protocol for postoperative care following laser photocoagulation for ROP. Frequent examinations including close evaluation of the anterior segment are critical in diagnosing pupillary block and angle closure glaucoma. Immediate treatment limits vision loss associated with this complication. Conclusions: Early detection of pupillary block may limit morbidity from angle closure following laser photocoagulation for ROP.
A.K. Sawchyn.
Classification:
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
9.4.5.5 Other (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
