Neodymium:yttrium-aluminum-garnet laser arteriotomy with embolectomy for central retinal artery occlusion

PURPOSE: To describe a patient with central retinal artery occlusion successfully treated with neodymium:yttrium-aluminum-garnet laser arteriotomy and embolectomy. DESIGN: Interventional case report. METHODS: A 77-year-old woman noted sudden loss of vision after vigorous coughing. A central retinal artery occlusion was diagnosed. Four hours after symptoms appeared, arteriotomy and embolectomy with neodymium:yttrium-aluminum-garnet laser was performed. RESULTS: Displacement of embolus outside the artery with return of retinal perfusion and recovery of vision. Laser treatment also resulted in vitreous hemorrhage and false aneurysm formation of the central retinal artery. CONCLUSIONS: Neodymium:yttrium aluminum-garnet laser arteriotomy in a patient with central retinal artery occlusion resulted in extrusion of the embolus, reopening of the central retinal artery, and return of vision. This technique warrants further study as a primary treatment for this blinding disorder.