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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

RETINAL Cases & Brief Reports: Summer 2014 - Volume 8 - Issue 3 - p 183–186
doi: 10.1097/ICB.0000000000000038
Case Report

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.

Postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy is described, in the literature, because of leakage of small-diameter open sclerotomies. However, the authors' objective is to report a case of long-term hypotony because of accidental break, with scleral tunnel entrapment, of a 23-gauge microcannula during transconjunctival sutureless vitrectomy.

Vitreoretinal Department, Centro Privado de Ojos Romagosa-Fundación VER, Córdoba, Argentina.

Reprint requests: José D. Luna, MD, Departamento de Oftalmología, Centro Privado de Ojos Romagosa-Fundación VER, Deán Funes 432, 5000 Córdoba, Argentina; e-mail: fundacionver@gmail.com

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.