Endothelial Adherence of Asteroid Bodies Following Nd: YAG Laser Posterior Capsulotomy—An Unhealthy Union

Asteroid hyalosis (AH) is a vitreous condition where yellow-white refractile spherical particles, often called “asteroid bodies,” are found inside the vitreous cavity. AH was initially called “asteroid hyalitis” by Benson in 1894. However, in the absence of inflammation, it was renamed later. The etiology of AH remains to be proved. Here, we report the case of an elderly male, a known case of glaucoma on medications, who presented with progressive visual deterioration for 7 months after laser posterior capsulotomy in the right eye. He had undergone uncomplicated cataract surgery with posterior intraocular lens placement (PCIOL) in both eyes 10 years ago. The right eye showed calcium-like white deposits on the corneal endothelium associated with corneal edema and a well-centered PCIOL with a posterior capsulotomy opening and no vitreous prolapse. Fundus revealed AH in the right eye. After performing anterior segment optical coherence tomography, a diagnosis of endothelial adherence of asteroid bodies was made. The patient was managed conservatively. Prolapse of AH from the vitreous into the anterior chamber can occur not only following uncomplicated cataract extraction but also after a laser posterior capsulotomy. These particles may adhere to a compromised corneal endothelium and cause corneal edema with a subsequent decrease in vision.