Late-onset descemet membrane detachment and corneal decompensation after laser peripheral iridotomy: A case report

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Rationale:The incidence of cornea disorders after laser peripheral iridotomy (LPI) is extremely low. However, cornea Descemet membrane detachment (DMD) combined with corneal decompensation after LPI could still occur.Patient concerns:A 69-year-old Chinese woman presented with persistent widespread corneal edema and inferior bullous lesions in her right eye for half a year. She had undergone LPI in both eyes 10 years ago for a prophylactic treatment. The patient received a detailed examination of vivo corneal confocal microscopy and sept-source optical coherence tomography (SS-OCT).Diagnoses:It was a late-onset DMD that has a positional relationship with LPI, combined with corneal decompensation.Intervention:Treatment was only supportive with artificial tears and soft contact lenses.Outcomes:This patient declined to accept keratoplasty because of financial difficulties.Lessons:Laser peripheral iridotomy may cause spontaneous, late-onset DMD and corneal decompensation. Ophthalmologists should be aware of this potential complication and proceed carefully. A careful examination of cornea especially around the LPI before keratoplasty seems to be necessary to circumvent other complication.

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