Li Gai-Yun, Alantaree Samer, Wang Jun-Ming, Zhang Hong
From the Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Medicine (Baltimore). 2016 Mar;95(9):e2907. doi: 10.1097/MD.0000000000002907.
Ocular decompression retinopathy (ODR), a rare postoperative complication following glaucoma surgery, is characterized by the transient appearance of scattered retinal hemorrhages. Here, we present a unique case of ODR in a patient with primary open angle glaucoma who underwent canaloplasty. A 31-year-old male patient presented with an intraocular pressure (IOP) of 60 mm Hg in the right eye. The IOP remained over 40 mm Hg, even when treated with maximum tolerated antiglaucoma medication. Canaloplasty drastically lowered IOP in the right eye from 40 to 7 mm Hg. However, fundus examination revealed ODR after surgery. The patient was treated with tobramycin and dexamethasone. Three months after canaloplasty, IOP remained in control at 16 mm Hg and all retinal hemorrhages had completely resolved. This case demonstrates that ODR can occur following canaloplasty and physicians should be aware of this potential complication in patients with severely elevated IOP. Sufficiently lowering IOP before surgery and gradually decreasing IOP during surgery may prevent ODR from occurring.
眼部减压性视网膜病变（ODR）是青光眼手术后一种罕见的术后并发症，其特征是视网膜出现散在性出血，呈一过性。在此，我们报告一例原发性开角型青光眼患者行睫状体光凝术（canaloplasty）后发生ODR的独特病例。一名31岁男性患者右眼眼压（IOP）为60 mmHg。即使使用最大耐受量的抗青光眼药物治疗，眼压仍维持在40 mmHg以上。睫状体光凝术使右眼眼压从40 mmHg大幅降至7 mmHg。然而，术后眼底检查发现了ODR。患者接受了妥布霉素和地塞米松治疗。睫状体光凝术三个月后，眼压控制在16 mmHg，所有视网膜出血已完全消退。该病例表明，睫状体光凝术后可能发生ODR，医生应意识到眼压严重升高患者存在这种潜在并发症。术前充分降低眼压并在手术过程中逐渐降低眼压可能预防ODR的发生。
