RESUMO
Retinal detachment after ocular perforation related to local anesthesia is a common complication, which is usually associated with a poor prognosis despite complex vitreoretinal surgical procedures. We report a case of 62-year-old male with cataract surgery done 4 weeks back with nasal retinal detachment with a posterior break. Pneumatic retinopexy was performed and laser barrage of the breaks was done the next day when the retina got attached. A vision of 20/30 was achieved at the end of 2 months. To the best of our knowledge, this is a first case report in literature where pneumatic retinopexy was used to manage a retinal detachment caused by block-related perforation.
Assuntos
Anestesia Local/efeitos adversos , Ferimentos Oculares Penetrantes/complicações , Complicações Intraoperatórias , Procedimentos Cirúrgicos Oftalmológicos/métodos , Retina/cirurgia , Descolamento Retiniano/cirurgia , Ferimentos Oculares Penetrantes/diagnóstico , Ferimentos Oculares Penetrantes/cirurgia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Retina/lesões , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologiaRESUMO
A patient with idiopathic retinal vasculitis was found to have rapid conversion of serological tests for Treponema pallidum and HIV. The diagnosis was confirmed by Venereal Disease Research Laboratory (VDRL) testing and dark ground illumination for T. pallidum, and enzyme-linked immunosorbent assay (ELISA) and Western blot assay tests for HIV. Following treatment with intravenous penicillin, the fundus lesions resolved and visual acuity recovered from inaccurate light projection to 6/24 in the right eye and from counting fingers close to face to 2/60 in the left eye. Serological tests for T. pallidum in patients with concurrent HIV infection may be unpredictable. Hence, it is important to repeat these tests even in the early treatment phase of patients with retinal vasculitis who have shown initial seronegativity. This enables earlier diagnosis and initiation of specific treatment.
Assuntos
Infecções Oculares Bacterianas/diagnóstico , Soropositividade para HIV/diagnóstico , Doenças Retinianas/diagnóstico , Sorodiagnóstico da Sífilis , Sífilis/diagnóstico , Treponema pallidum/imunologia , Vasculite/diagnóstico , Adulto , Anticorpos Antibacterianos/análise , Western Blotting , Ensaio de Imunoadsorção Enzimática , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/microbiologia , Soropositividade para HIV/tratamento farmacológico , Soropositividade para HIV/microbiologia , Humanos , Masculino , Penicilinas/uso terapêutico , Doenças Retinianas/tratamento farmacológico , Doenças Retinianas/microbiologia , Sífilis/tratamento farmacológico , Sífilis/microbiologia , Vasculite/tratamento farmacológico , Vasculite/microbiologia , Acuidade VisualRESUMO
Injection of corticosteroids into the posterior subtenon space is a well established and highly effective modality in the treatment of intermediate uveitis. The conventional technique of posterior subtenon injection involves the use of a sharp tipped 26-gauge, 5/8 inch needle that must be inserted up to its hub to obtain adequate placement of the drug into the posterior subtenon space. With this technique the risk of perforation of the globe, although minimal, remains a potential complication. Herein is described a new technique for injection of corticosteroids into the posterior subtenon space using an intravenous cannula made of polytetrafluoroethylene (PFTE) that allows safer delivery of the drug into the posterior subtenon space.