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21st Annual Meeting of the German Retina Society and 8th Symposium of the International Society of Ocular Trauma (ISOT)

German Retina Society
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

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Scleral perforation and postoperative hypotony as a possible complication of extraocular buckling surgery

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  • Jörg C. Schmidt - Marburg/Germany
  • S. Mennel - Marburg/Germany

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008V043

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/rg2008/08rg044.shtml

Published: June 18, 2008

© 2008 Schmidt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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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.