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RETINAL Cases & Brief Reports:
doi: 10.1097/ICB.0000000000000038
Case Report

LONG-TERM HYPOTONY BECAUSE OF ACCIDENTAL BREAK OF A 23 G MICROCANNULA AFTER TRANSCONJUNCTIVAL SUTURELESS VITRECTOMY

Gramajo, Ana L. MD; Meyer, Mariano MD; Juárez, Claudio P. MD, PhD; Luna, José D. MD

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Abstract

Purpose:

To report a case of long-lasting hypotony because of accidental break, with scleral tunnel entrapment, of a 23-gauge microcannula during transconjunctival sutureless vitrectomy.

Methods:

Interventional case report. An 80-year-old Spanish woman who underwent 23-gauge transconjunctival sutureless vitrectomy presented at the postoperative ocular examination with irreversible, refractory low intraocular pressure of unknown cause. Two weeks after surgery, a piece of the microcannula was found at the inferotemporal sclerotomy site during a scheduled medical appointment. Surgical intervention was indicated to explore and remove the foreign body.

Results:

The day after foreign body extraction, the patient's pressure rose to normal levels. However, her visual acuity did not improve until 3 weeks later.

Conclusion:

Transient postoperative hypotony is unsurprising after 23-gauge vitrectomy because of leakage of small-diameter open sclerotomies. However, when long-term low intraocular pressure fails to return to normal levels because of an unidentified condition, breaking of the microcannula piece with scleral tunnel entrapment may be contemplated.

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