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KMID : 1038920150140040223
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Annals of Optometry and Contact Lens
2015 Volume.14 No. 4 p.223 ~ p.226
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Giant Retinal Tear by Jamming of 23-gauge Instrument in the Cannula during Vitrectomy for Dense Vitreous Hemorrhage
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Eum Sun-Jung
Shin Jae-Pil
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Abstract
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Purpose: We report a rare case of intraoperative giant retinal tear caused by completely jammed 23-gauge instrument in the cannula during vitrectomy for dense vitreous hemorrhage.
Case summary: A 41-year-old man presented with visual disturbance in the left eye. Uncorrected visual acuity was 20/20 for right eye and hand motion in the left eye which was not corrected. The patient was diagnosed with dense vitreous hemorrhage related to branch retinal vein occlusion in the left eye. We performed 23-gauge vitrectomy, and the vitreous cutter was firmly jammed inside the cannula intraoperatively. The jammed cannula had to be removed along with the cutter and a new cannula was reinserted through the sclerotomy site. A giant retinal break was detected around the replaced cannula during peripheral vitrectomy. Perfluorocarbon liquid was used to unfold the inverted flap of the retinal tear and the operation was finished by applying laser photocoagulation and silicone oil tamponade.
Conclusions: The 23-gauge vitrectomy instrument may be jammed in the cannula during vitrectomy for dense vitreous hemorrhage, and the trapped vitreous can cause retinal break by traction. Therefore, dense vitreous hemorrhage around the cannula should be carefully removed to prevent iatrogenic intraoperative retinal break prior to core vitrectomy.
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KEYWORD
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Retinal detachment, Vitrectomy, Vitreous hemorrhage
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