title: Central retinal artery occlusion after radial optic neurotomy in a patient with central retinal vein occlusion.
abstract: OBJECTIVE
  To describe a patient with a central retinal vein occlusion (CRVO) who developed central retinal artery occlusion after radial optic neurotomy.
  
  
  METHODS
  Interventional case report.
  
  
  METHODS
  A 70-year-old woman with CRVO underwent a radial optic neurotomy on her right eye. Her preoperative visual acuity in the affected eye was 20/400.
  
  
  RESULTS
  Radial optic neurotomy was performed after phacoemulsification and aspiration for a cataract with intraocular lens implantation. At the insertion of a CRVO knife, pulsating bleeding occurred from the cup of the optic disk; the bleeding was stopped within 2 minutes by elevating the intraocular pressure to 80 mm Hg. On the following day, the patient noticed that she had lost light perception. Fluorescein angiography showed a marked delay of arterial filling, indicating a central retinal artery occlusion. Retinal circulation returned to normal 2 months later; however, her vision was still no light perception.
  
  
  CONCLUSIONS
  Ophthalmologists should be aware that severe complications such as central retinal artery occlusion can be associated with radial optic neurotomy, which is an unproven surgical procedure with a questionable pathophysiologic mechanism.
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan. shuyama@faculty.chiba-u.ac.jp
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Takatsuna
authors.forename: Eiju
authors.initials: E
authors.lastname: Sato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mizunoya
mesh_terms: D000368:Aged; D001766:Blindness / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D019654:Lens Implantation, Intraocular; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D009898:Optic Disk / Q000098:blood supply / Q000601:surgery*; D009900:Optic Nerve / Q000098:blood supply / Q000601:surgery*; D018918:Phacoemulsification; D015356:Retinal Artery Occlusion / Q000209:etiology*; D012170:Retinal Vein Occlusion / Q000601:surgery*; D014792:Visual Acuity