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A case of choroidal effusion with associated dramatic proptosis during cataract surgery

Poster Details

First Author: T.Murphy IRELAND

Co Author(s):    P. O'Reilly                    

Abstract Details

Purpose:

To examine the factors that caused intraoperative choroidal effusion in this case, to convey a detailed review of the case, to examine the postoperative outcome, to explore the published literature

Setting:

University Hospital Limerick,Ireland

Methods:

KP, a 65yo lady with no previous ophthalmic history and VA of 6/12 presented for left eye phacoemulsifaction and IOL insertion. Pre-operative examination and medical observations were normal. She received a routine subtenons block with xylocaine and adrenaline mixed with hyaluronidase prior to commencing cataract surgery. Side port incision was made. The anterior chamber was noted to dramatically shallow with associated irido-corneal touch. It then rapidly deepened, with loss of the red reflex. The eye then underwent dramatic proptosis, but was not tense on palpation. The cataract surgery was halted.

Results:

The patient was examined one hour post operatively. Visual acuity was 'counting fingers'. Anterior chamber remained very deep. The eye was well formed, but soft. Significantly, proptosis had resolved. B-scan ultrasound confirmed the globe was well formed. CT orbits were performed day one post operatively, with no scleral perforation observed. Choroidal detachments were present on fundal examination. The patient was observed over the following three weeks, with VA returning gradually to 6/12, IOP to 10, and resolution of choroidals.

Conclusions:

Choroidal effusion during cataract surgery is a rare complication, with minimal documentation in the literature. There is no published literature documenting associated proptosis. Hyaluronidase allergy is a contributing factor in this case. Thus, choroidal effusion with associated dramatic proptosis is a significant and rare intraoperative complication of cataract surgery.

Financial Disclosure:

NONE

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