Pars plana vitrectomy under melphalan irrigation for recurrent retinal detachment in eyes treated for retinoblastoma: a case report

Purpose: Presumed venous air embolism (PVAE) is a rare and potentially fatal complication of pars plana vitrectomy that is poorly described and understood but requires improved awareness among ophthalmologists and vitreoretinal surgeons. Methods: A case report is presented along with a systematic review of published reports of PVAE during ocular surgery. Results: An otherwise healthy adult male undergoing retinal detachment repair under local anesthesia with monitored anesthesia care died from a PVAE. Literature search yielded 2 experimental models, 6 individual case reports, and several editorials. Review of existing reports reveals that PVAE can affect patients of any age or gender with no medical predilection and occurs in cases of trauma, endoresection, or retinal detachment repair. It is typically associated with a drop in end-tidal carbon dioxide during fluid–air exchange and can present similar to a hemorrhagic choroidal detachment. Analysis suggests that venous air embolism can be prevented by ensuring full engagement of the infusion cannula into the vitreous cavity prior to fluid–air exchange. Conclusion: Presumed venous air embolism is a potentially fatal complication of ocular surgery and in some cases may be recognized by ophthalmologists as a choroidal detachment during fluid–air exchange in pars plana vitrectomy. It is imperative to immediately stop the air infusion line if venous air embolism is suspected.

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Neuro-Ophthalmological Emergencies. Are They Always Innocent? A Case Report and a Literature Review

10.47363/jnrrr/2021(3)143 ◽

2021 ◽

pp. 1-9

Author(s):

Anthoula C Tsolaki ◽

◽

Thomas Tegos ◽

Ioannis N Chalkias ◽

Efthymios Chalkias ◽

...

Keyword(s):

Case Report ◽

Retinal Detachment ◽

Literature Review ◽

Respiratory Distress ◽

Pars Plana Vitrectomy ◽

Neurological Complications ◽

Ophthalmic Surgery ◽

Tractional Retinal Detachment ◽

Peribulbar Block ◽

Pars Plana

Neuro-ophthalmogical complications are rare but can be serious after regional block. We present a case of a 54-year-old diabetic patient who was scheduled for pars plana vitrectomy of his right eye due to tractional retinal detachment, under a peribulbar block with a mixture of lidocaine and ropivacaine. He presented with tachycardia, hypertension, seizures, respiratory distress and apnea. He was intubated for less than 24 hours. He was discharged with no neurological deficit. A review regarding these rare but serious neurological complications of ophthalmic surgery is presented, to raise awareness of neurologists, who are called to evaluate and treat these patients

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Faculty Opinions recommendation of Pars Plana Vitrectomy Alone for the Management of Pseudophakic Rhegmatogenous Retinal Detachment with Only Inferior Breaks.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726321782.793521905 ◽

2016 ◽

Author(s):

Joseph Moisseiev

Keyword(s):

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Pars Plana

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Microperimetry-Assessed Functional Alterations and OCT-Changes in Patients after Retinal Detachment Surgery Using Pars Plana Vitrectomy and SF6 Tamponade

Diagnostics ◽

10.3390/diagnostics11071157 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1157

Author(s):

María D. Díaz-Barreda ◽

Isabel Bartolomé-Sesé ◽

Ana Boned-Murillo ◽

Antonio Ferreras ◽

Elvira Orduna-Hospital ◽

...

Keyword(s):

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Structural Changes ◽

Cross Sectional Study ◽

Retinal Sensitivity ◽

Cross Sectional ◽

Swept Source ◽

Integrity Assessment ◽

Integrity Index ◽

Pars Plana

Background: We study the retinal function measured by macular integrity assessment microperimetry (MAIA) and structural changes assessed by scanning swept source optical coherence tomography (SS-OCT) between healthy individuals and patients undergoing pars plana vitrectomy (PPV) after rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study. Early Treatment Diabetic Retinopathy Study (ETDRS) grids were measured by SS-OCT and compared with the MAIA parameters. Results: Thirty-eight eyes with RRD (19 macula-on and 19 macula-off) were compared with 113 healthy eyes. The retinal sensitivity and average total threshold were reduced in all sectors in the RRD group; macular integrity index was increased. Macular thicknesses in total retina and ganglion cell layer (GCL)++ protocols were higher in the RRD group in nasal outer (NO) and central (C) sectors and only in C sector for GCL+ protocol. Thicknesses were lower in total retina, GCL++ protocols in the temporal outer (TO) sector and in the GCL+ protocol in NO sector. Best-corrected visual acuity (BCVA) correlated moderately with retinal sensitivity in all sectors and in just several sectors with time between the date of surgery and the test. The central nasal (CN) sector thickness and the average total threshold were higher in the macula-on subgroup. Conclusions: RRD and subsequent surgery results in functional and structural changes, especially in individuals with macular detachment.

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