To the Editor.
—Transient intraocular pressure (IOP) elevations following neodymium-YAG laser posterior capsulotomy have been reported.1-5 No relation between the refractive error or axial length or both and the prevalance or severity of IOP elevation has been suggested. Trabecular meshwork obstruction with capsular remnants, cortical debris, and inflammatory cells has been proposed to explain the decreased outflow facility.3,5 We recently treated two patients (three eyes) with high axial myopia who developed unusually high IOP elevations. The IOP spike was not associated with significant intraocular inflammation, anterior chamber debris, or acute pupillary block.
Report of Cases.—Case 1.
—A 25-year-old woman with best corrected visual acuity of 20/20+ (aphakic correction, +3.50 +1.25 × 120, axial length, 25.4 mm) after extracapsular cataract extraction (ECCE) without IOL implantation underwent a 2.0-mm posterior capsulotomy (Figure). The Q-switched pulses were as follows: two pulses per burst, 0.6 millijoule per pulse, with a