J Korean Ophthalmol Soc.  2007 Aug;48(8):1158-1162.

Two Cases of Ocular Ischemia following Scleral Encircling

Affiliations
  • 1Kong Eye Center, Seoul, Korea. euklee@chol.com

Abstract

PURPOSE: To report two cases of ocular ischemia following scleral encircling.
METHODS
A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear.
RESULTS
Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis.
CONCLUSIONS
In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.

Keyword

Central retinal artery occlusion; Ophthalmic artery occlusion; Scleral encircling

MeSH Terms

Aged
Anesthesia
Anterior Chamber
Conjunctiva
Cryotherapy
Female
Glaucoma
Humans
Ischemia*
Mannitol
Muscles
Ophthalmic Artery
Paracentesis
Retinal Artery Occlusion
Retinal Detachment
Retinal Perforations
Young Adult
Mannitol

Figure

  • Figure 1. Case 1 (A) Fundus photograph at 1 day after surgery. The orange reflex stands out on the thin foveola, in contrast to surrounding pale retina, giving rise to the cherry-red spot appearance. Narrowing of the retinal arteries is also noted. (B) Fluorescein angiograph at 25 seconds after injection. It shows that choroidal flushing markedly decreased and there is no filling of inferior retinal artery. The arterial filling time and arteriovenous transit time also are delayed remarkably.

  • Figure 2. Case 2 (A) Fundus photograph at 1 day after surgery. It shows that there is whitening or opacification of the superficial retina and a cheery-red spot. (B) Fluorescein angiograph at 18 seconds after injection. It shows that delay in retinal arterial filling and prolongation of arteriovenous transit time. (C) Optical coherence tomograph. It shows subretinal fluid retention and macular edema.


Reference

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