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Argon laser iridotomy-induced bullous keratopathy—a growing problem in Japan
  1. Leonard P K Ang1,2,3,4,
  2. Hisayo Higashihara1,
  3. Chie Sotozono1,
  4. Vijay A Shanmuganathan1,5,
  5. Harminder Dua5,
  6. Donald T H Tan2,3,4,
  7. Shigeru Kinoshita1
  1. 1
    Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  2. 2
    Singapore National Eye Centre, Singapore
  3. 3
    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  4. 4
    Singapore Eye Research Institute, Singapore
  5. 5
    Division of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, UK
  1. Shigeru Kinoshita, Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-0841 Japan; shigeruk{at}


Aims: To describe the long-term risk of bullous keratopathy following argon laser iridotomy (ALI) in Japan and to compare it with other centres in the world.

Methods: We retrospectively reviewed the case records of all patients with ALI-induced bullous keratopathy that underwent penetrating keratoplasty at Kyoto Prefectural University of Medicine (KPUM) from January 2001 to December 2004. The results were compared with the other representative centres in Singapore and the UK.

Results: Thirty-nine eyes of 33 patients were included in the study. The mean age of patients was 73.3±6.9 years (range, 58 to 87 years). Patients developed bullous keratopathy at a mean duration of 6.9±4.9 years (range, 0.2 to 16 years) after the laser iridotomy procedure. The majority of eyes that developed bullous keratopathy (59.0%) occurred following prophylactic ALI. KPUM had the highest percentage of ALI-induced bullous keratopathy cases that underwent penetrating keratoplasties, as compared with other centres in Singapore and the UK (20.0%, 1.8% and 0%, respectively).

Conclusion: Bullous keratopathy may arise many years following ALI, and is a growing problem in Asian countries. This condition is a major cause of ocular morbidity in Japan, which has seen a worrying increase in the number of cases in recent years.

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  • Commercial interests: The authors have no commercial interest in any of the material discussed in the paper.

  • Financial support: None.

  • Abbreviations:

    argon laser iridotomy


    Kyoto Prefectural University of Medicine


    Nottingham Queen’s Medical Centre


    Singapore National Eye Centre