Central retinal artery occlusion after Descemet membrane reposition by intracameral air: A case report.

Abstract:

PURPOSE:To report a case of central retinal artery occlusion after Descemet membrane reposition by intracameral air. METHODS:An otherwise healthy 60-year-old woman presented with white mature cataract in her left eye. Ocular exam of both eyes was within normal limits. After an uneventful topical phacoemulsification, a moderate-grade striate keratopathy and non-planar Descemet membrane detachment was noted on first postoperative day, which was confirmed on anterior segment optical coherence tomography. The Descemet membrane was repositioned within 24 h of cataract extraction by intracameral air tamponade (pneumatic descematopexy) under topical anesthesia, and partial air release was done after 2 h. The patient was evaluated for decreased immediate postoperative vision of perception of light. RESULTS:After pneumatic descematopexy, the stromal edema relatively cleared. The intraocular pressure before releasing the intracameral air was 38 mmHg and antiglaucoma medication was started. Dilated fundus exam showed retinal pallor and a cherry-red spot over the macula. A diagnosis of central retinal artery occlusion was confirmed, and thorough systemic workup was done. Systemic investigations were within normal limits. The patient was managed conservatively, but the final visual acuity remained at 1/60. CONCLUSION:Central retinal artery occlusion is not a reported complication after pneumatic descematopexy for Descemet membrane detachment management. The possible mechanism could be sudden increase in intraocular pressure due to pupil block by air, and thus, ocular surgeries with use of intracameral air for prolonged duration warrants close monitoring of intraocular pressure and its subsequent management.

journal_name

Eur J Ophthalmol

authors

Meena AK,Ghodke BR,Parmar GS

doi

10.1177/1120672119870740

subject

Has Abstract

pub_date

2019-08-21 00:00:00

pages

1120672119870740

eissn

1120-6721

issn

1724-6016

pub_type

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