Farah Akhtar.
Aqueous misdirection syndrome as a complication of Neodymium:YAG posterior capsulotomy.
Al-Shifa J Ophthalmol Jan ;2(2):70-2.

Objective: To highlight aqueous misdirection syndrome as a rare complication of Nd:YAG posterior capsulotomy performed for posterior capsule opacification (PCO) Study Design: Case report. Participant: A 50 year old psuedophakic female who had Nd:YAG posterior capsulotomy six days before for posterior capsule opacification developed rise in intraocular pressure associated with flat anterior chamber. Methods: After brief history and a detailed ocular examination full-thickness iridotomy was performed with Nd:YAG laser. Patent iridotomy did not reduce the intraocular pressure. A-scan ultrasonography was performed which showed aqueous pockets in vitreous, leading to diagnosis of aqueous misdirection syndrome. Medical therapy comprising atropine, 0.5% timolol, mannitol, and acetazolamide was given. Anterior vitrectomy to disrupt un-interrupted anterior vitreous face was carried out to reduce vitreous volume and to reform anterior chamber. Results: Medical and surgical therapy normalized intraocular pressure and resolved symptoms of aqueous misdirection syndrome. Conclusion: Aqueous misdirection syndrome can be a rare and serious complication of Nd:YAG posterior capsulotomy where early recognition is crucial. The role of echographic examination is also emphasized which must be performed as soon as possible.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com