Pupil Ovalization and Accommodation Loss after High-intensity Focused Ultrasound Treatment for Glaucoma: A Case Report

AIM: The aim of this study is to present a complication derived from high-intensity focused ultrasound (HIFU) not described previously in the literature. BACKGROUND: HIFU has shown to be an effective technique for reducing intraocular pressure (IOP) in the treatment of glaucoma, enabling the selective coagulation of the ciliary body. Published trials have not observed major intra- or postoperative complications, or serious adverse events derived from this technique. CASE DESCRIPTION: We present the case of a 65-year-old phakic patient with open-angle glaucoma and no previous filtration surgery. He was treated in both eyes with HIFU. After the intervention, the patient presented mild uveitis for 10 days, which remitted with the application of topical cycloplegic and corticosteroid treatment. After that, he reported a loss of near vision and examination showed pupil ovalization. It persisted 6 months later, with an accommodation loss of one diopter. CONCLUSION: Phakic patients treated with HIFU might be at risk of pupil ovalization with accommodation loss. CLINICAL SIGNIFICANCE: The complications described in this article should be included in the informed consent for patients with glaucoma who are offered HIFU as a treatment option. HOW TO CITE THIS ARTICLE: Rivero-Santana A, Pérez-Silguero D, et al. Pupil Ovalization and Accommodation Loss after High-intensity Focused Ultrasound Treatment for Glaucoma: A Case Report. J Curr Glaucoma Pract 2019;13(2):77–78.