Ulnar Neuropathy as a Complication of Retinal Detachment Surgery

Hae Jung Sun; Soon Chul Baek; Kyung Seek Choi; Sung Jin Lee

doi:10.3341/jkos.2009.50.6.942

Journal List > J Korean Ophthalmol Soc > v.50(6) > 1008590

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Sun, Baek, Choi, and Lee: Ulnar Neuropathy as a Complication of Retinal Detachment Surgery

Original Article

J Korean Ophthalmol Soc 2009;50(6):942-945.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.6.942

Ulnar Neuropathy as a Complication of Retinal Detachment Surgery

Hae Jung Sun, MD, Soon Chul Baek, MD, Kyung Seek Choi, MD, PhD, Sung Jin Lee, MD, PhD

Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, Korea

Address reprint requests to Sung Jin Lee, MD, PhD Department of Ophthalmology, Soonchunhyang University Hospital #22 Daesaguan-gil, Yongsan-gu, Seoul 140-743, Korea TEL: 82-2-709-9354, FAX: 82-2-798-7797 E-mail: wismile@unitel.co.kr

Received 17 November 2008 Accepted 25 March 2009

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 a case of ulnar neuropathy as an extraocular complication following retinal detachment surgery and face-down positioning.

Case summary

A 65-year-old woman was referred to our hospital with decreased visual acuity in the left eye. Fundus examination revealed a rhegmatogenous retinal detachment not involving the macula in the left eye. A vitrectomy with scleral encircling and 18% SF6 gas tamponade was performed. The patient was instructed to assume a face-down position. After 5 days, the patient reported having paresthesia and numbness of the left 4th and 5th fingers. Neurologic exams were performed and the results indicated ulnar neuropathy. There was no improvement in the neurologic symptoms during the 6-month follow-up.

Conclusions

Surgeons performing retinal surgery should caution their patients of ulnar neuropathy when face-down positioning is required. The patients should be instructed to minimize the time spent with their elbows flexed in a stationary position. Additionally, the pressure loaded on the bent elbow should be minimized.

Keywords: Face-down positioning, Gas tamponade, Retinal detachment, Ulnar neuropathy, Vitrectomy

References

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Figure 1.

Body position of the patient. The patient spent most of the time with her arms flexed, applying pressure on the bent elbows. Sitting (A), bowing down (B), and lying on her stomach (C, D).

Figure 2.

Neurophysiologic test of the right (A) and left (B) ulnar nerve. The evoked muscle action potential in the left ulnar nerve with stimulation proximal to the elbow (solid arrow) was less than 50% of the potential obtained with stimulation of the wrist (dotted arrow). The finding was consistent with sustained compression injury of the left ulnar nerve.

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