Photic retinal injury from endoillumination during vitrectomy.
We treated a patient who developed a paramacular area of light-induced retinal damage after endoscopic epimacular membrane removal. Postoperative color photographs showed complete absence of the membrane, but fluorescein angiography demonstrated a previously absent superior paramacular lesion consistent with a photic injury. Operative microscope illumination had been eliminated by corneal shielding, which implicated endoillumination as the source of injury. We recommend the following procedures to avoid this complication: careful planning of vitreous surgery for epimacular membrane removal; using filters; minimizing the length of surgery; keeping the light output low; maintaining maximal light pipe distance from the retina; eccentric orientation of the light pipe; and use of intermittent and variable site illumination techniques.
Kuhn
F
F
Helen Keller Eye Research Foundation, Birmingham, AL 35233.
Morris
R
R
Massey
M
M
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008027:Light / Q000009:adverse effects*; D010781:Photography; D012160:Retina / Q000528:radiation effects*; D012164:Retinal Diseases / Q000517:prevention & control; D014821:Vitrectomy / Q000009:adverse effects* / Q000379:methods