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Bilateral pulmonary emboli following macular hole surgery with postoperative prone positioning
Daniel A Brill1, Taylor S Fields1, Anjali U Badami1
1Henry Ford Hospital, Department of Ophthalmology, Detroit, MI, USA.
Purpose:
To report a rare case of bilateral pulmonary emboli following pars plana vitrectomy with postoperative prone positioning.
Observations:
A 60 year-old female presented with a fourmonth history of unilateral distorted vision. Ocular coherence tomography revealed a full thickness macular hole. Two weeks later, the patient underwent a 23-gauge pars plana vitrectomy with internal limiting membrane peeling and 12% perfluoropropane gas tamponade. Postoperatively, she completed two weeks of prone positioning. Five days later, she presented with a two day history of abdominal pain and shortness of breath. Computed tomography angiography revealed bilateral pulmonary emboli. The patient received six months of anticoagulation to prevent further thromboembolic events.
Conclusions:
Life threatening blood clots can form due to prolonged immobilization from prone positioning. Patients should be educated to perform light exercise postoperatively to prevent complications of blood stasis.
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