Gross anterior segment ischaemia following vitreoretinal surgery for sickle-cell retinopathy

Abstract

We report the case of a 32-year-old Afrocaribbean man with known stage 3 proliferative sickle-cell retinopathy who presented with a mixed picture of tractional and rhegmatogenous macula off detachment. He underwent left primary 25 g vitrectomy with silicone oil, delamination and endolaser photocoagulation under a general anaesthetic. He, however, presented 48 hours postoperatively with gross anterior segment ischaemia. His pain and ocular signs settled over the course of a few days following administration of supplemental oxygen, oral steroids, analgesia and intravenous hydration. Examination showed resolution of his proptosis and orbital signs as well as anterior segment inflammation. He remains under follow-up.

Acute anterior segment ischemia following transconjunctival vitrectomy for retinal detachment

“…Auch eine dichte Laserapplikation der peripheren avaskulären Netzhaut bei Frühgeborenenretinopathie kann eine VAA-Ischämie bedingen, vermutlich auch über Fallberichte beschreiben auch nach Vitrektomie und Laser bei Sichelzellanämie VAA-Ischämien. Mikrozirkulationsstörungen im Rahmen der Grundkrankheit werden hier vermutlich die Entwicklung von Ischämien begünstigen [10].…”