Laser iridocystotomy for bilateral acute angle-closure glaucoma secondary to iris cysts

Abstract

Purpose: To report laser iridocystotomy for bilateral acute angle-closure glaucoma secondary to peripheral iris cysts.

Method: Case report.

Results: In a 55-year-old man with increased bilateral intraocular pressure, gonioscopy revealed varied angle narrowing. Bilateral angle-closure glaucoma secondary to peripheral iris cysts was diagnosed by ultrasound biomicroscopy. The peripheral iris cysts could not be seen in mydriasis by gonioscopy. Therefore, we decided to perform laser iridocystotomy with argon and Nd:YAG laser. Collapse of the cysts after laser treatment was demonstrated by ultrasound biomicroscopy. At follow-up, 9 months after laser treatment, intraocular pressure had dropped below 20 mm Hg in both eyes without further therapy. The iris cysts did not recur, which was demonstrated by ultrasound biomicroscopy.

Conclusions: Peripheral iris cysts may produce angle closure and may cause secondary angle-closure glaucoma. If transpupillary laser cystotomy is not possible, laser iridocystotomy may produce collapse of the iris cysts and correction of secondary angle closure.