Background: To report a possibility of mechanical injury following laser iridotomy (LI) via the iris surface to the corneal endothelium possibly causing bullous keratopathy.
Case: Subjects were two patients with plateau iris configuration who had been given LI bilaterally. One eye of each patient showed serious decrease in cellular density of the corneal endothelium. Cataract surgery was carried out in these two eyes. We performed ultrasound biomicroscopy in supine and prone positions for eight directions and specular microscopy for nine directions. Data were compared before and after the surgery. Significant endothelial loss was observed in the lower part of cornea in the two eyes. In the same area, the angular part of the plateau iris was attached to the cornea above the Schwalbe line was also shown in prone position. After the cataract surgery, the attachment was relieved, and the cellular density value of endothelium was increased in the lower area while the value was decreased in other areas. Thereafter, the endothelial decrease stopped.
Conclusion: The contact between the iris root and the corneal endothelium might be one cause of bullous keratopathy in eyes with plateau iris following LI.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 119: 68-76, 2015.