Complete but transient visual loss after yttrium aluminum garnet laser transscleral cyclocoagulation

We report the case of a patient who had no light perception after neodymium:yttrium aluminum garnet (Nd:YAG) laser transscleral cyclocoagulation. To the best of our knowledge, no similar cases have been reported previously. A 56-year-old man with intractable open-angle glaucoma had intraocular pressures of 42 mmHg OD and 35mmHg OS. The patient rejected a recommended filtering operation, although argon laser trabeculoplasty and maximal medication had been ineffective OU. We used the free-running mode of an Nd:YAG laser to treat this patient. After the tenth application, the patient suddenly noticed acute visual loss OD. He was admitted to the hospital immediately. His retinal vessels and papilla OD could not be seen during fluorescein angiography. We administered pulsed corticosteroids and a stellate ganglion block. Gradually, his symptoms improved. The indications for using Nd:YAG laser cyclocoagulation have been expanded. However, as a result of our experience in this patient, we concluded that such therapy should be limited to cases not amenable to other forms of medical and surgical treatment.