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 Table of Contents  
PHOTO ESSAY
Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 822-823

Endothelial adherence of asteroid bodies following Nd:YAG laser posterior capsulotomy


1 Comprehensive Services, Centre for Sight Eye Institute, Dwarka, New Delhi, India
2 Glaucoma and Cataract Services, Centre for Sight Eye Institute, Dwarka, New Delhi, India
3 Cornea and Refractive Services, Centre for Sight Eye Institute, Dwarka, New Delhi, India
4 Cataract and Refractive Surgery Services, Centre for Sight Eye Institute, Dwarka, New Delhi, India

Date of Submission18-Apr-2022
Date of Acceptance19-May-2022
Date of Web Publication16-Jul-2022

Correspondence Address:
Dr. Isha Chaturvedi
Flat Number 803/B, NHAI Residential Enclave, Dwarka, New Delhi - 110 078
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_970_22

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  Abstract 


Keywords: Asteroid hyalosis, corneal endothelium, posterior capsulotomy, vitreous prolapse


How to cite this article:
Chaturvedi I, Patyal S, Koul A, Thulasidas M. Endothelial adherence of asteroid bodies following Nd:YAG laser posterior capsulotomy. Indian J Ophthalmol Case Rep 2022;2:822-3

How to cite this URL:
Chaturvedi I, Patyal S, Koul A, Thulasidas M. Endothelial adherence of asteroid bodies following Nd:YAG laser posterior capsulotomy. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Aug 13];2:822-3. Available from: https://www.ijoreports.in/text.asp?2022/2/3/822/351221



An 88-year-old male presented with diminution of vision since 7 months following laser posterior capsulotomy in the right eye (RE). He was a known case of bilateral open-angle glaucoma on topical medications. His visual acuity was hand movements in RE and intraocular pressure was 14 mmHg. On examination, there were fine calcium-like deposits on the corneal endothelium, denser inferiorly, diffuse stromal edema, well-centered posterior chamber intraocular lens (PCIOL), and posterior capsulotomy opening without any vitreous in the anterior chamber (AC) [Figure 1]. Fundus examination showed asteroid hyalosis (AH) in RE and bilateral advanced glaucomatous cupping. Anterior segment optical coherence tomography of RE showed hyper-reflective deposits on corneal endothelium with diffuse stromal edema [Figure 2]. Specular microscopy of RE could not be obtained, while the left eye (LE) showed polymegathism and pleomorphism [Figure 3]. The patient refused any surgical intervention and was managed conservatively. At the last follow-up of 5 months, he had additionally developed ocular surface problems with resultant central stromal opacities and hypertrophic epithelium [Figure 4].
Figure 1: Slit-lamp photograph showing the presence of asteroid bodies on corneal endothelium with central corneal stromal edema at presentation

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Figure 2: Anterior segment optical coherence tomography of the right eye showing hyper-reflective calcium deposits of asteroids on corneal endothelium with diffuse stromal edema

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Figure 3: Specular microscopy of the left eye showing increased coefficient of variation and reduced hexagonality of endothelial cells

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Figure 4: Slit-lamp photograph showing persistently adherent asteroid bodies with central stromal opacities and hypertrophied epithelium at final follow-up

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  Discussion Top


AH is a condition where yellow-white refractile particles, called “asteroid bodies,” are found inside the vitreous cavity.[1] It is commonly unilateral, male-predominant, and associated with increasing age after the sixth decade.[2] Prolapse of asteroid bodies into the AC following uneventful cataract surgery has been reported only twice in the literature.[3],[4] We believe that, in our case, the asteroid bodies partially seeped into the AC through the capsulotomy or a pre-existing area of zonular dehiscence that got disturbed during capsulotomy. Benzalkonium chloride (BAK), a common preservative in glaucoma medications, causes corneal toxicity and subclinical AC inflammation.[5] These factors could have contributed to a compromised endothelium leading to the adherence of the asteroid bodies. To the best of our knowledge, this is the first reported case of endothelial adherence of asteroid bodies following laser posterior capsulotomy.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Tripathy K. Asteroid hyalosis. N Engl J Med 2018;379:e12.  Back to cited text no. 1
    
2.
Moss SE, Klein R, Klein BE. Asteroid hyalosis in a population: The Beaver Dam eye study. Am J Ophthalmol 2001;132:70-5.  Back to cited text no. 2
    
3.
Shields CL, Romanelli-Gobbi M, Lally SE, Shields JA. Vitreous asteroid hyalosis prolapse into the anterior chamber simulating iris metastasis. Middle East Afr J Ophthalmol 2012;19:346-8.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Desai A, Kaza H, Takkar B, Choudhari N. Anterior migration of asteroid hyalosis due to aqueous misdirection: Asteroids in the wrong orbit. BMJ Case Rep 2021;14:e246441. doi: 10.1136/bcr-2021-246441.  Back to cited text no. 4
    
5.
Rasmussen CA, Kaufman PL, Kiland JA. Benzalkonium chloride and glaucoma. J Ocul Pharmacol Ther 2014;30:163-9.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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