title: Refractory open-angle glaucoma after neodymium-yttrium-aluminum-garnet laser lysis of vitreous floaters.
abstract: OBJECTIVE
  To illustrate 3 cases of chronic open-angle glaucoma secondary to the neodymium-yttrium-aluminum-garnet (Nd:YAG) laser vitreolysis procedure for symptomatic vitreous floaters.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Location of the study was the Doheny Eye Institute. Three eyes of 2 patients who developed chronic open-angle glaucoma after Nd:YAG vitreolysis for symptomatic floaters presenting with very high intraocular pressure (IOP >40 mm Hg) were selected. The time from the laser treatment to the onset of elevated pressure ranges from 1 week to 8 months. There was no associated inflammation, steroid use, or other identifiable cause of chronic IOP elevation.
  
  
  RESULTS
  All eyes were treated initially with glaucoma medication, followed by selective laser trabeculoplasty (SLT) and eventually glaucoma surgery (Trabectome) in 2 eyes for disease management. In all eyes, intraocular pressures were eventually stabilized within a normal pressure range from 18 to 38 months following Nd:YAG vitreolysis. At the latest follow-up post surgery, all eyes had intraocular pressures of 22 mm Hg or less with or without medications.
  
  
  CONCLUSIONS
  Secondary open-angle glaucoma is a complication of Nd:YAG vitreolysis for symptomatic floaters that may present with an increase in intraocular pressure immediately, or many months after the surgery. Furthermore this complication may be permanent and require chronic medical therapy or glaucoma surgery.
authors.affiliation: Department of Ophthalmology, University of Southern California, Los Angeles, California.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cowan
authors.affiliation: Department of Ophthalmology, University of Southern California, Los Angeles, California.
authors.forename: Kay T
authors.initials: KT
authors.lastname: Khine
authors.affiliation: Department of Ophthalmology, University of Southern California, Los Angeles, California.
authors.forename: Vikas
authors.initials: V
authors.lastname: Chopra
authors.affiliation: Amerisight Institute and Valley Eye Center, Van Nuys, California.
authors.forename: Doreen T
authors.initials: DT
authors.lastname: Fazio
authors.affiliation: Department of Ophthalmology, University of Southern California, Los Angeles, California. Electronic address: bfrancis@doheny.org.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Francis
mesh_terms: D000535:Aluminum; D005128:Eye Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D053844:Lasers, Solid-State / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009354:Neodymium; D011183:Postoperative Complications; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D014822:Vitreous Body / Q000601:surgery; D015019:Yttrium
chemical_list: C503779:yttrium-aluminum-garnet; D009354:Neodymium; D015019:Yttrium; D000535:Aluminum