Argon laser iridotomy-induced bullous keratopathy a growing problem in Japan.
OBJECTIVE
To describe the long-term risk of bullous keratopathy following argon laser iridotomy (ALI) in Japan and to compare it with other centres in the world.


METHODS
We retrospectively reviewed the case records of all patients with ALI-induced bullous keratopathy that underwent penetrating keratoplasty at Kyoto Prefectural University of Medicine (KPUM) from January 2001 to December 2004. The results were compared with the other representative centres in Singapore and the UK.


RESULTS
Thirty-nine eyes of 33 patients were included in the study. The mean age of patients was 73.3+/-6.9 years (range, 58 to 87 years). Patients developed bullous keratopathy at a mean duration of 6.9+/-4.9 years (range, 0.2 to 16 years) after the laser iridotomy procedure. The majority of eyes that developed bullous keratopathy (59.0%) occurred following prophylactic ALI. KPUM had the highest percentage of ALI-induced bullous keratopathy cases that underwent penetrating keratoplasties, as compared with other centres in Singapore and the UK (20.0%, 1.8% and 0%, respectively).


CONCLUSIONS
Bullous keratopathy may arise many years following ALI, and is a growing problem in Asian countries. This condition is a major cause of ocular morbidity in Japan, which has seen a worrying increase in the number of cases in recent years.
Ang
Leonard P K
LP
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-0841 Japan.
Higashihara
Hisayo
H
Sotozono
Chie
C
Shanmuganathan
Vijay A
VA
Dua
Harminder
H
Tan
Donald T H
DT
Kinoshita
Shigeru
S
D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D015715:Corneal Edema / Q000209:etiology / Q000473:pathology; D019793:Fluorescein; D005456:Fluorescent Dyes; D006801:Humans; D015994:Incidence; D007498:Iris / Q000601:surgery*; D007564:Japan / Q000453:epidemiology; D015948:Keratoplasty, Penetrating; D053685:Laser Therapy / Q000009:adverse effects*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013194:Staining and Labeling; D013997:Time Factors
D005456:Fluorescent Dyes; D019793:Fluorescein