Transient Deficit of Accommodation After Laser Barrage for Retinal Tear

To report a case of transient loss of accommodation after laser photocoagulation for peripheral retinal tear. Loss of accommodation is one of the lesser known and less common complications of peripheral retinal laser photocoagulation. In fact, only a few works concerning this issue have been published so far. Deficit of accommodation has been described only after extensive laser treatment of the peripheral retina. To the best of our knowledge, this is the first case that reports this complication after treatment limited to a small retinal area. We discuss the possible pathogenetic mechanism of this phenomenon.

A 25-year-old healthy myopic woman came to the eye clinic for flashes and floaters in her right eye. Fundus evaluation revealed a small horseshoe retinal tear at the 6 o'clock position. She was treated with prophylactic retinal laser barrage in the right eye. Twelve days later, she returned to our Retinal Clinic because of difficulty with near vision. The problem started soon after the laser procedure. On examination, her distance visual acuity was 20/20 wearing her glasses. The patient could read J1+ at 33 cm with the left eye and required a +3.00D addition over her corrective lens to read J1+ with the right eye. The accommodative disturbance resolved itself spontaneously and gradually within 3 months of laser treatment.

We believe that transient loss of accommodation, although rare, should be included during pretreatment discussion with young patients regarding the possible side effects of laser photocoagulation, even if this is limited to a small area of the peripheral retina.