IATROGENIC MACULAR HOLE BECAUSE OF NEODYMIUM:YTTRIUM-ALUMINUM-GARNET-SELECTIVE LASER TRABECULOPLASTY LASER: CASE REPORT AND MANAGEMENT

Retin Cases Brief Rep. 2025 Jan 1;19(1):91-94. doi: 10.1097/ICB.0000000000001517.

Abstract

Purpose: To report a case of a patient who suffered a full-thickness macular hole because of the accidental utilization of the selective laser trabeculoplasty mode of a dual mode laser.

Method: Case report.

Results: A 69-year-old woman experienced vision loss in her left eye immediately after undergoing attempted neodymium:yttrium-aluminum-garnet capsulotomy using a neodymium:yttrium-aluminum-garnet-selective laser trabeculoplasty laser system. Postinjury visual acuity was 20/25 and 20/800 in the right and left eyes, respectively. Ophthalmic examination and multimodal imaging revealed multiple macular hemorrhages and an irregular full-thickness macular hole. The patient required multiple surgeries including an autologous retinal transplant to achieve hole closure.

Conclusion: Macular hole formation is a devastating consequence of inadvertent use of the selective laser trabeculoplasty mode when performing a neodymium:yttrium-aluminum-garnet laser capsulotomy with a neodymium:yttrium-aluminum-garnet-selective laser trabeculoplasty laser system. The authors emphasize the importance of ensuring the correct mode is selected for treatment to minimize the risk of retinal damage and permanent vision loss.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aluminum
  • Female
  • Humans
  • Iatrogenic Disease
  • Laser Therapy / adverse effects
  • Laser Therapy / methods
  • Lasers, Solid-State* / adverse effects
  • Lasers, Solid-State* / therapeutic use
  • Retinal Perforations* / diagnosis
  • Retinal Perforations* / etiology
  • Retinal Perforations* / surgery
  • Tomography, Optical Coherence
  • Trabeculectomy* / adverse effects
  • Visual Acuity
  • Yttrium

Substances

  • yttrium-aluminum-garnet
  • Aluminum
  • Yttrium