The blood-aqueous barrier breakdown in eyes with endothelial decompensation after argon laser iridotomy

Argon laser iridotomy-induced bullous keratopathy (ALI-BK) is a growing medical problem in Asian countries.1 This disease is a common reason for either Descemet's stripping automated endothelial keratoplasty or penetrating keratoplasty surgery in Japan.2 3 Our experience with penetrating keratoplasty, combined with cataract extraction and intraocular lens implantation in eyes with ALI-BK, is typically characterised by an aggressive anterior-chamber inflammatory response, both intraoperatively and postoperatively, as compared with pseudophakic and aphakic BK, corneal opacity, and corneal scarring. Therefore, we speculate that in eyes with ALI-BK, the disease tends to weaken the blood-aqueous barrier. We quantitatively evaluated the blood-aqueous barrier in eyes with early endothelial decompensation following ALI using iris fluorescein angiography (IFA) and fluorophotometry. This study involved nine eyes of seven patients with early endothelial decompensation following ALI, as well as eight eyes of four normal volunteers as a control. Relevant ethical committees approved the study protocol. A slit-lamp anterior fluorophotometer (FL-500; Kowa Company, Nagoya, Japan) was used to measure the blood-aqueous barrier function.4 After the autofluorescence values in the anterior chamber were measured, an intravenous injection of 10 ml of 10% sodium fluorescein solution was administered. At 10 and 30 min after the injection, the fluorescence intensity value in the anterior chamber was …