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Kim, Kang, Rhim, and Lee: Two Cases of Ocular Ischemia following Scleral Encircling
Original Article

J Korean Ophthalmol Soc 2007;48(8):1158-1162.

Published online: 24 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.8.1158-1162

Two Cases of Ocular Ischemia following Scleral Encircling

Hyung-Su Kim, M.D., Kyeong-Bok Kang, M.D., Won-IL Rhim, M.D., Eun-Koo Lee, M.D.

Kong Eye Center, Seoul, Korea

Address reprint requests to Eun Koo Lee, M.D., Kong Eye Center, #139 Sungnae-2dong, Gangdong-gu, Seoul 134-841, Korea, Tel: 82-2-480-5000, Fax: 82-2-480-5001, E-mail: euklee@chol.com

Received 8 December 2006       Accepted 3 May 2007

Copyright © 2007 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report two cases of ocular ischemia following scleral encircling.

Methods

A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear.

Results

Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis.

Conclusions

In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.

Keywords: Central retinal artery occlusion, Ophthalmic artery occlusion, Scleral encircling

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Figure 1.
Case 1 (A) Fundus photograph at 1 day after surgery. The orange reflex stands out on the thin foveola, in contrast to surrounding pale retina, giving rise to the cherry-red spot appearance. Narrowing of the retinal arteries is also noted. (B) Fluorescein angiograph at 25 seconds after injection. It shows that choroidal flushing markedly decreased and there is no filling of inferior retinal artery. The arterial filling time and arteriovenous transit time also are delayed remarkably.
jkos-48-1158f1.tif
Figure 2.
Case 2 (A) Fundus photograph at 1 day after surgery. It shows that there is whitening or opacification of the superficial retina and a cheery-red spot. (B) Fluorescein angiograph at 18 seconds after injection. It shows that delay in retinal arterial filling and prolongation of arteriovenous transit time. (C) Optical coherence tomograph. It shows subretinal fluid retention and macular edema.
jkos-48-1158f2.tif
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