Severe proptosis during cataract surgery
Purpose: We report an unusual case of severe proptosis during phacoemulsification in a 58-year-old female with a history of Crohn's disease, bilateral chronic panuveitis, prior bilateral central retinal vein occlusion, and uncontrolled steroid-associated ocular hypertension requiring bilateral...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
|
| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993623001093 |
| _version_ | 1827591542195355648 |
|---|---|
| author | Lauren Ton Wanlin Zhang Murtaza Saifee Anushka Walia Julius Oatts Ying Han |
| author_facet | Lauren Ton Wanlin Zhang Murtaza Saifee Anushka Walia Julius Oatts Ying Han |
| author_sort | Lauren Ton |
| collection | DOAJ |
| description | Purpose: We report an unusual case of severe proptosis during phacoemulsification in a 58-year-old female with a history of Crohn's disease, bilateral chronic panuveitis, prior bilateral central retinal vein occlusion, and uncontrolled steroid-associated ocular hypertension requiring bilateral Ahmed glaucoma drainage device (GDD) implantation with pars plana tube placement. Observations: During phacoemulsification of the right eye, the patient developed significant proptosis. Following lid speculum removal and mechanical eyelid manipulation, the proptosis resolved within 20 minutes without requiring a lateral canthotomy. The patient had no permanent visual complications. Conclusions and Importance: The likely pathophysiology of intraoperative proptosis in this case was accumulation of fluid in the retrobulbar space due to a functioning Ahmed tube shunt with the tube placed in the vitreous cavity. To avoid this complication, concurrent cataract surgery may be considered for patients with pars plana tube placement GDD surgery. |
| first_indexed | 2024-03-09T01:34:14Z |
| format | Article |
| id | doaj.art-5fe3cbeea57247b5a9a201fb56601313 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-03-09T01:34:14Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-5fe3cbeea57247b5a9a201fb566013132023-12-09T06:07:11ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362023-12-0132101901Severe proptosis during cataract surgeryLauren Ton0Wanlin Zhang1Murtaza Saifee2Anushka Walia3Julius Oatts4Ying Han5School of Medicine, University of California San Francisco, San Francisco, CA, USAUniversity of California Berkeley, Berkeley, CA, USADepartment of Ophthalmology, University of California San Francisco, San Francisco, CA, USASchool of Medicine, University of California San Francisco, San Francisco, CA, USADepartment of Ophthalmology, University of California San Francisco, San Francisco, CA, USADepartment of Ophthalmology, University of California San Francisco, San Francisco, CA, USA; Corresponding author. Department of Ophthalmology, University of California San Francisco, 490 Illinois Street, San Francisco, CA, 94131, USA.Purpose: We report an unusual case of severe proptosis during phacoemulsification in a 58-year-old female with a history of Crohn's disease, bilateral chronic panuveitis, prior bilateral central retinal vein occlusion, and uncontrolled steroid-associated ocular hypertension requiring bilateral Ahmed glaucoma drainage device (GDD) implantation with pars plana tube placement. Observations: During phacoemulsification of the right eye, the patient developed significant proptosis. Following lid speculum removal and mechanical eyelid manipulation, the proptosis resolved within 20 minutes without requiring a lateral canthotomy. The patient had no permanent visual complications. Conclusions and Importance: The likely pathophysiology of intraoperative proptosis in this case was accumulation of fluid in the retrobulbar space due to a functioning Ahmed tube shunt with the tube placed in the vitreous cavity. To avoid this complication, concurrent cataract surgery may be considered for patients with pars plana tube placement GDD surgery.http://www.sciencedirect.com/science/article/pii/S2451993623001093ProptosisGlaucoma drainage devicePhacoemulsification |
| spellingShingle | Lauren Ton Wanlin Zhang Murtaza Saifee Anushka Walia Julius Oatts Ying Han Severe proptosis during cataract surgery American Journal of Ophthalmology Case Reports Proptosis Glaucoma drainage device Phacoemulsification |
| title | Severe proptosis during cataract surgery |
| title_full | Severe proptosis during cataract surgery |
| title_fullStr | Severe proptosis during cataract surgery |
| title_full_unstemmed | Severe proptosis during cataract surgery |
| title_short | Severe proptosis during cataract surgery |
| title_sort | severe proptosis during cataract surgery |
| topic | Proptosis Glaucoma drainage device Phacoemulsification |
| url | http://www.sciencedirect.com/science/article/pii/S2451993623001093 |
| work_keys_str_mv | AT laurenton severeproptosisduringcataractsurgery AT wanlinzhang severeproptosisduringcataractsurgery AT murtazasaifee severeproptosisduringcataractsurgery AT anushkawalia severeproptosisduringcataractsurgery AT juliusoatts severeproptosisduringcataractsurgery AT yinghan severeproptosisduringcataractsurgery |