Anterior segment ischemia and retinal detachment after vertical rectus muscle surgery.
OBJECTIVE
The authors describe the clinical course of a woman who developed two complications following vertical strabismus repair: anterior segment ischemia (ASI) and retinal detachment.


METHODS
A 62 year-old woman is described. She presented with new onset proptosis and left hypertropia with significant diplopia in all fields of gaze. This presentation, her 15 year history of thyroid disease, and preoperative computed tomography (CT) of the orbits were consistent with Graves' ophthalmopathy. Vertical strabismus repair was carried out by recessing the left superior rectus muscle and resecting the left inferior rectus muscle.


RESULTS
The diplopia was eliminated. The patient developed significant postoperative ASI and iatrogenic rhegmatogenous retinal detachment in the left eye due to unsuspected globe perforation. She was treated with systemic corticosteroids and radial scleral buckling.


CONCLUSIONS
Severe ASI following strabismus surgery is a well recognized complication, with age, thyroid ophthalmopathy, and manipulation of the vertical rectus muscles as risk factors. The retinal detachment soon after strabismus surgery was difficult to detect, possibly due to diminished visualization of the posterior segment as a result of ASI.
Wolf
E
E
Department of Ophthalmology, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark 07103-2499, USA.
Wagner
R S
RS
Zarbin
M A
MA
D000869:Anterior Eye Segment / Q000098:blood supply*; D015807:Eye Injuries, Penetrating / Q000209:etiology* / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D015590:Fluorophotometry; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications; D007511:Ischemia / Q000209:etiology*; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D012160:Retina / Q000293:injuries*; D012163:Retinal Detachment / Q000209:etiology* / Q000601:surgery; D012591:Scleral Buckling; D013285:Strabismus / Q000601:surgery*; D014792:Visual Acuity
D005938:Glucocorticoids