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Late-onset descemet membrane detachment and corneal decompensation after laser peripheral iridotomy

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Rationale: The incidence of cornea disorders after laser peripheral iridotomy (LPI) is extremely low. However, cornea Descemet membrane detachment (DMD) combined with corneal decompensation after LPI could still occur. Patient… Click to show full abstract

Rationale: The incidence of cornea disorders after laser peripheral iridotomy (LPI) is extremely low. However, cornea Descemet membrane detachment (DMD) combined with corneal decompensation after LPI could still occur. Patient concerns: A 69-year-old Chinese woman presented with persistent widespread corneal edema and inferior bullous lesions in her right eye for half a year. She had undergone LPI in both eyes 10 years ago for a prophylactic treatment. The patient received a detailed examination of vivo corneal confocal microscopy and sept-source optical coherence tomography (SS-OCT). Diagnoses: It was a late-onset DMD that has a positional relationship with LPI, combined with corneal decompensation. Intervention: Treatment was only supportive with artificial tears and soft contact lenses. Outcomes: This patient declined to accept keratoplasty because of financial difficulties. Lessons: Laser peripheral iridotomy may cause spontaneous, late-onset DMD and corneal decompensation. Ophthalmologists should be aware of this potential complication and proceed carefully. A careful examination of cornea especially around the LPI before keratoplasty seems to be necessary to circumvent other complication.

Keywords: late onset; corneal decompensation; laser peripheral; decompensation; peripheral iridotomy

Journal Title: Medicine
Year Published: 2018

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