title: Acute hyperopic shift in refraction associated with posterior choroidal detachment following phacoemulsification surgery.
abstract: OBJECTIVE
  To describe a patient who presented with hyperopic shift as an initial manifestation of choroidal detachment in the posterior pole following an uneventful phacoemulsification cataract surgery.
  
  
  METHODS
  An 82-year-old woman with preexisting diabetes mellitus and hypertension had bilateral primary angle closure glaucoma on maximal tolerated hypotensive medication. An uneventful phacoemulsification surgery using topical anesthesia was performed in her left eye.
  
  
  RESULTS
  On the next day, refraction was markedly increased to +7.25 -1.00 × 65 and axial length was reduced from 23.24 mm to 20.13 mm. Funduscopic examination revealed choroidal detachment in the posterior pole without involvement of the peripheral fundus. Axial length increased to 22.19 mm following corticosteroid treatment 1 month later. Six months postoperatively, axial length improved to 22.87 mm with a residual hyperopia of +1.00 -1.00 × 63.
  
  
  CONCLUSIONS
  To our knowledge, there have been no reports of choroidal detachment in the posterior pole after phacoemulsification. Acute hyperopic shift following phacoemulsification surgery should lead one to suspect a posterior choroidal detachment. Considering axial length and refractive errors along with fundus examination may contribute to a more accurate follow-up.
authors.affiliation: Department of Health Management, I-Shou University, Kaohsiung, Taiwan. yylee@mail.vhyk.gov.tw
authors.forename: Yin-Yang
authors.initials: YY
authors.lastname: Lee
authors.forename: Shwu-Jiuan
authors.initials: SJ
authors.lastname: Sheu
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D058452:Axial Length, Eye / Q000473:pathology; D015862:Choroid Diseases / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D006956:Hyperopia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D018918:Phacoemulsification / Q000009:adverse effects*; D012029:Refraction, Ocular / Q000187:drug effects / Q000502:physiology*; D012422:Rupture, Spontaneous; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids