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B. Y. Ebrahim, L. Frohman, N. Bhagat; Tonic Pupil Following Pars Plana Vitrectomy and Endolaser. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5233.
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To describe two cases of tonic pupil after pars plana vitrectomy (PPV) and endolaser for retinal detachment repair.
Retrospective case series
Two male psuedophakic patients with non-traumatic rhegmatogenous retinal detachment developed tonic pupil following retinal detachment repair with pars plana vitrectomy, endolaser. Both cases were performed under monitored anesthesia care using retrobulbar blocks. One patient underwent oil tamponade; the oil was removed 3 months after the initial repair but the tonic pupil has continued for 6 months after surgery. The other patient underwent gas tamponade with C3F8-12% and the tonic pupil remains 5 months after the surgery.
Tonic pupil is a possible complication of PPV and endolaser with retrobulbar anesthesia. The most likely mechanism is the additive injurious effect of the endolaser and the local anesthetic injection. The most probable site of disturbance is the short ciliary nerves along their course anteriorly.
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