A Rare Case Of Decompression Retinopathy In A Post-Phacoemulsification Filipino With Phacolytic Glaucoma

2 weeks prior to consult, a 60-year-old male patient noted severe left eye pain and blurring of vision. Patient presented with visual acuity of light perception on the left eye. Slit lamp examination showed grade 2 corneal haze with diffuse microcysts, Morgagnian cataract, a 1.5mm layer of white lens proteins deposited in the inferior anterior chamber, +1 cells, +3 flare, deep anterior chamber, and intraocular pressure of 40mmHg. Patient was assessed as phacolytic glaucoma. 

Patient then underwent phacoemulsification to remove the lens material. Anterior vitrectomy was done intra-operatively due to posterior capsule rupture. A three-piece intraocular lens was then implanted in the sulcus. On the first post-operative day, patient had visual acuity of hand movement with good light projection. Intraocular pressures maintained at 40mmHg. On dilated funduscopy, there were multiple blot hemorrhages scattered across the retina until the mid periphery. Patient was then advised to observe the intraretinal hemorrhages. Over the next few weeks, the intraretinal hemorrhages slowly spontaneously resolved until the retina was clear of any hemorrhages at 5 weeks post-operation. Visual acuity maintained at hand movement with good light projection during the observation period.

Decompression retinopathy does not only happen with glaucoma filtration surgeries, but can occur with any surgery that rapidly decreases intraocular pressures. Decompression retinopathy carries a benign course and resolves with prompt observation.