Wise Justin, Toygar Okan, Corrêa Zélia M, Miller Daniel M, Sisk Robert A
*College of Medicine, University of Cincinnati, Cincinnati, Ohio; †Cincinnati Eye Institute, Cincinnati, Ohio; ‡Department of Ophthalmology, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey; and §Department of Ophthalmology, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Retin Cases Brief Rep. 2017;11(1):79-82. doi: 10.1097/ICB.0000000000000294.
To report a case of inadvertent subretinal cannulation of ab externo suture trabeculotomy surgery associated with serous macular detachment.
Retrospective case report. Ophthalmic examination and portable spectral domain optical coherence tomography (Envisu C2300; Bioptogen, Morrisville, NC) were performed under general anesthesia.
A 5-year-old girl with uveitis secondary to oligoarticular juvenile idiopathic arthritis underwent trabeculotomy surgery of the left eye for steroid-induced glaucoma refractory to medical management. The surgery was complicated by inadvertent subretinal cannulation with the prolene suture. Multiple, arcuate, hypopigmented subretinal tracks, originating from the ora serrata, were observed. Spectral domain optical coherence tomography images through the macula revealed subretinal fluid overlying funduscopically visible tracks, defects in photoreceptor outer segments overlying the tracks, and normal choroidal anatomy. The serous macular detachment resolved spontaneously after 4 months and visual acuity returned to baseline 20/25 in the left eye, consistent with reversible localized damage to the outer retina and retinal pigment epithelium.
We report a case of inadvertent subretinal cannulation during suture trabeculotomy surgery that resulted in serous macular detachment which resolved spontaneously. The inadvertent complication demonstrated a pathway for administration of therapeutics to the subretinal space.
报告1例外部巩膜瓣小梁切开术意外发生视网膜下置管并伴有浆液性黄斑脱离的病例。
回顾性病例报告。在全身麻醉下进行眼科检查和便携式谱域光学相干断层扫描（Envisu C2300；Bioptogen公司，北卡罗来纳州莫里斯维尔）。
一名5岁患有寡关节型幼年特发性关节炎继发葡萄膜炎的女孩因药物治疗无效的类固醇性青光眼接受了左眼小梁切开术。手术因普理灵缝线意外插入视网膜下而出现并发症。观察到多条从锯齿缘发出的弓形、色素减退的视网膜下条索。通过黄斑的谱域光学相干断层扫描图像显示，视网膜下液覆盖在眼底可见的条索上，条索上方的光感受器外节存在缺损，脉络膜解剖结构正常。浆液性黄斑脱离在4个月后自发消退，左眼视力恢复到基线20/25，这与外视网膜和视网膜色素上皮的可逆性局部损伤一致。
我们报告了1例小梁切开术期间意外发生视网膜下置管导致浆液性黄斑脱离且自行消退的病例。这一意外并发症展示了一种向视网膜下间隙给药的途径。
