Artikel
Scleral perforation and postoperative hypotony as a possible complication of extraocular buckling surgery
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Autoren
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Jörg C. Schmidt
- Marburg/Germany
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S. Mennel
- Marburg/Germany
| Veröffentlicht: | 18. Juni 2008 |
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Gliederung
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Background: Scleral perforation is a possible complication of extraocular buckling surgery. Early diagnostic and treatment is essential to avoid further side effects.
Material and methods: A 43-year-old male complained decrease of visual acuity at the right eye. A half year before a retinal detachment OD was treated by buckling surgery. Following consecutive reattachment of the retina and increase of visual acuity, one month after surgery the patient again complained a deterioration of visual acuity and by this time a hypotony was diagnosed. The treatment by this time was an application of intravitreal triamcinolone and fill up of the anterior chamber with viscoelastics.
Results: At the first consultation in our department visual acuity was 0,3 and the intraocular pressure 4 mmHg. The anterior chamber was deep, the retina attached and at the central border of the buckle a depigmentation became evident. As a scleral perforation was suspected, a pars plana Vitrectomy with phacoemulsification and IOL implantation was performed. By removal of the buckle a scleral opening of 1mm and adjacent necrotic could be demonstrated. The nectrotic scleral tissue did not enable suturing. A scleral patch was necessary to tamponade the scleral opening and intraocular silicone oil was inserted. The postoperative ocular pressure was normal.
Conclusion: Postoperative hyopotony following extraocular buckling surgery could be a sign of intraoperative scleral perforation. This serious complication requires adequate diagnostic and treatment to avoid complications as endophthalmitis, retinal incarceration, cystoid maculopathy or phthisis bulbi.
