Ocular decompression retinopathy after deep sclerectomy with mitomycin C in an eye with exfoliation glaucoma

To present a case of ocular decompression retinopathy occurring after an uncomplicated nonpenetrating glaucoma procedure (deep sclerectomy with mitomycin C).

A 52-year-old man with medically uncontrolled exfoliation glaucoma in the left eye underwent uneventful deep sclerectomy with mitomycin C. The patient had no history or laboratory evidence of any bleeding disorder.

On the first postoperative day, visual acuity fell from the preoperative level of Snellen 0.2 to hand movement and the intraocular pressure was 5 mmHg. Funduscopy revealed a small intravitreal hemorrhage and multiple, extended retinal hemorrhages in all quadrants of the fundus. After standard postoperative medication with antibiotic/steroid eyedrops, the patient's visual acuity returned to preoperative levels and the retinal hemorrhages were absorbed. Three and a half months postoperatively, the fundus was free of bleedings.

Although decompression retinopathy has previously been described after penetrating glaucoma surgery, the condition can also occur after uncomplicated deep sclerectomy. Despite the dramatic presentation, the prognosis remains favorable.