The cause of pigment epithelial tears at the edge of a pigment epithelial detachment (PED) following transpupillary thermotherapy (TTT) in eyes with a PED associated with age-related macular degeneration has not been conclusively determined. We have treated two eyes that had a PED with TTT. A pigment epithelial tear developed in one eye but not in the other. Our findings suggest that pigment epithelial tears are probably related to the shape of the PED, and TTT should not be applied to a balloon-shaped PED.