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March 1985

Central Retinal Artery Occlusion Following YAG Synechialysis

Arch Ophthalmol. 1985;103(3):325-326. doi:10.1001/archopht.1985.01050030021008

To the Editor.  —The intraocular pressure (IOP) rise following neodymium-YAG laser surgery has been the subject of several recent studies. Terry et al1 presented a series of 49 eyes in which the IOPs exceeded 41 mm Hg in seven. Channell and Beckman2 presented a series of 57 eyes in which the largest increase in IOP was 32 mm Hg above baseline. However, in all of these eyes, the postoperative pressure rise was managed without substantial loss of vision.In the past seven months, three case reports have appeared in the literature that describe a malignant rise of IOP following YAG-laser capsulotomy. Vine3 reported a pressure rise to greater than 80 mm Hg with central retinal artery occlusion. Immediate paracentesis resulted in restoration of vision. Parker et al4 reported a pressure rise to 67 mm Hg. This was controlled by pharmacologic means without visual loss. Blackwell et

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