Open-angle Glaucoma Following Neodymium-Yttrium-Aluminum-Garnet Laser Vitreolysis

Abstract

This report highlights a rare case of open-angle glaucoma requiring trabeculectomy following laser vitreolysis. A 66-year-old man developed uncontrolled open-angle glaucoma requiring trabeculectomy following three sessions of neodymiun-yttium-aluminum-garnet laser vitreolysis for floaters. Shortly after the third session, he developed highly labile intraocular pressures ranging from the low teens to 40 on maximum medical therapy, with rapid loss of retinal nerve fiber layer on optical coherence tomography and development of a superior arcuate defect into fixation on visual field over 4 weeks. Intraocular pressure (IOP) and glaucoma testing stabilized after trabeculectomy. This case illustrates the risk of uncontrolled IOP after laser vitreolysis, highlighting the importance of careful IOP monitoring after this procedure.