INTRACTABLE GLAUCOMA AFTER CAROTID ENDARTERECTOMY

Ocular ischemic syndrome is caused by chronic insufficiency of the blo od supply to the eye as a result of severe bilateral carotid artery st enosis or occlusion. The signs of ocular ischemia syndrome include ret inopathy (retinal microaneurysms, hemorrhages, and vein dilatation), c ataract, iris neovascularization (rubeosis iridis), and neovascular gl aucoma. The role of carotid endarterectomy in stabilizing and improvin g vision in patients with ocular ischemic syndrome is controversial. T he authors describe 2 patients with ocular ischemic syndrome and rubeo sis who, following carotid endarterectomy, developed an intractable ri se of intraocular pressure, which led to visual loss. The presence of rubeosis suggests poor visual prognosis and thus should be considered before a decision is made about carotid endarterectomy.