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Maurizio Uva, Antonio Longo, Michele Reibaldi, Mario Toro, Vincenza Bonfiglio, Faro Giuseppe, Andrea Russo, Caterina Gagliano, Teresio Avitabile; Acute serous retinal detachment after uncomplicated cataract surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):121.
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© ARVO (1962-2015); The Authors (2016-present)
To report some cases of acute serous retinal detachment (ASRD) after uncomplicated cataract surgery.
In a retrospective study, were collected the data of patients that developed an ASRD after an uncomplicated phacoemulsification with IOL implantation. Diagnosis was made at the first post-operative day, when all patients had a very low best corrected visual acuity (BCVA) in spite of a good aspect of the anterior segment, without significant keratopathy and with only trace cells in the anterior chamber; OCT revealed a serous retinal detachment with intraretinal fluid accumulation in macular area. Patients received systemic treatment with indomethacin 20 mg QD and acetazolamide 125 mg TID, and topical indomethacin 0.1% eyedrops in addition to usual post-operative treatment (topical: tropicamide 1% BID, steroids and antibiotics QID; oral cefixime 400 mg QD for 5 days). Patients were examined postoperatively at 1, 3, 7, and 30 days. BCVA and central foveal thickness (CFT), measured by a Spectral domain Spectralis OCT, were evaluated. It was evaluated if demographics, preoperative ocular conditions, systemic diseases, parameters of surgery were related to the development of ASRD.
From January 2009 to June 2012, on 3900 cataract surgery performed, an ASRD was detected in 5 patients (3m, 2f, mean age 59±9 years). Pre-operatively, mean BCVA was 0.16±0.09 decimals. At the first post-operative day, mean BCVA was 0.08±0.03 decimals, and CFT was 836±96 microns; all eyes had intraretinal fluid accumulation and serous retinal detachment. At the following controls, BCVA improved and CFT reduced significantly (both ANOVA p<0.001). At 3 days, mean BCVA was 0.36±0.11 decimals and mean CFT was 444±155 microns. At 7 days, BCVA was at least 0.8 decimals in all eyes (mean 0.90±0.07), with complete reabsorption of intra and subretinal fluid (mean CFT 210±8 microns). At 30 days, mean BCVA was 0.96±0.05 decimals and mean CFT was 191±12 microns. In the following six months, no eye had recurrence of macular edema. Preoperatively, all eyes had myopic refraction (axial length range: 24.8-27.4 mm), and had no posterior vitreous detachment; no relevant data were found on other parameters investigated.
Acute serous retinal detachment is a rare event that can occur after uncomplicated phacoemulsification, that in our cases resolved in a few days without recurrence.
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