Purpose:To report some cases of acute serous retinal detachment (ASRD) after uncomplicated cataract surgery. Methods:In a retrospective study, were collected the data of patients that developed an ASRD after an uncomplicated phacoemulsification with IOL implantation. Diagnosis was made at the first post-operative day, when all patients had a very low best corrected visual acuity (BCVA) in spite of a good aspect of the anterior segment, without significant keratopathy and with only trace cells in the anterior chamber; OCT revealed a serous retinal detachment with intraretinal fluid accumulation in macular area. Patients received systemic treatment with indomethacin 20 mg QD and acetazolamide 125 mg TID, and topical indomethacin 0.1% eyedrops in addition to usual post-operative treatment (topical: tropicamide 1% BID, steroids and antibiotics QID; oral cefixime 400 mg QD for 5 days). Patients were examined postoperatively at 1, 3, 7, and 30 days. BCVA and central foveal thickness (CFT), measured by a Spectral domain Spectralis OCT, were evaluated. It was evaluated if demographics, preoperative ocular conditions, systemic diseases, parameters of surgery were related to the development of ASRD. Results:From January 2009 to June 2012, on 3900 cataract surgery performed, an ASRD was detected in 5 patients (3m, 2f, mean age 59±9 years). Pre-operatively, mean BCVA was 0.16±0.09 decimals. At the first post-operative day, mean BCVA was 0.08±0.03 decimals, and CFT was 836±96 microns; all eyes had intraretinal fluid accumulation and serous retinal detachment. At the following controls, BCVA improved and CFT reduced significantly (both ANOVA p<0.001). At 3 days, mean BCVA was 0.36±0.11 decimals and mean CFT was 444±155 microns. At 7 days, BCVA was at least 0.8 decimals in all eyes (mean 0.90±0.07), with complete reabsorption of intra and subretinal fluid (mean CFT 210±8 microns). At 30 days, mean BCVA was 0.96±0.05 decimals and mean CFT was 191±12 microns. In the following six months, no eye had recurrence of macular edema. Preoperatively, all eyes had myopic refraction (axial length range: 24.8-27.4 mm), and had no posterior vitreous detachment; no relevant data were found on other parameters investigated. Conclusions:Acute serous retinal detachment is a rare event that can occur after uncomplicated phacoemulsification, that in our cases resolved in a few days without recurrence.

Acute serous retinal detachment after uncomplicated cataract surgery

UVA, Maurizio Giacinto;LONGO, ANTONIO;REIBALDI, MICHELE;Andrea Russo;Teresio Avitabile
2013

Abstract

Purpose:To report some cases of acute serous retinal detachment (ASRD) after uncomplicated cataract surgery. Methods:In a retrospective study, were collected the data of patients that developed an ASRD after an uncomplicated phacoemulsification with IOL implantation. Diagnosis was made at the first post-operative day, when all patients had a very low best corrected visual acuity (BCVA) in spite of a good aspect of the anterior segment, without significant keratopathy and with only trace cells in the anterior chamber; OCT revealed a serous retinal detachment with intraretinal fluid accumulation in macular area. Patients received systemic treatment with indomethacin 20 mg QD and acetazolamide 125 mg TID, and topical indomethacin 0.1% eyedrops in addition to usual post-operative treatment (topical: tropicamide 1% BID, steroids and antibiotics QID; oral cefixime 400 mg QD for 5 days). Patients were examined postoperatively at 1, 3, 7, and 30 days. BCVA and central foveal thickness (CFT), measured by a Spectral domain Spectralis OCT, were evaluated. It was evaluated if demographics, preoperative ocular conditions, systemic diseases, parameters of surgery were related to the development of ASRD. Results:From January 2009 to June 2012, on 3900 cataract surgery performed, an ASRD was detected in 5 patients (3m, 2f, mean age 59±9 years). Pre-operatively, mean BCVA was 0.16±0.09 decimals. At the first post-operative day, mean BCVA was 0.08±0.03 decimals, and CFT was 836±96 microns; all eyes had intraretinal fluid accumulation and serous retinal detachment. At the following controls, BCVA improved and CFT reduced significantly (both ANOVA p<0.001). At 3 days, mean BCVA was 0.36±0.11 decimals and mean CFT was 444±155 microns. At 7 days, BCVA was at least 0.8 decimals in all eyes (mean 0.90±0.07), with complete reabsorption of intra and subretinal fluid (mean CFT 210±8 microns). At 30 days, mean BCVA was 0.96±0.05 decimals and mean CFT was 191±12 microns. In the following six months, no eye had recurrence of macular edema. Preoperatively, all eyes had myopic refraction (axial length range: 24.8-27.4 mm), and had no posterior vitreous detachment; no relevant data were found on other parameters investigated. Conclusions:Acute serous retinal detachment is a rare event that can occur after uncomplicated phacoemulsification, that in our cases resolved in a few days without recurrence.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/20.500.11769/57641
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