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Unintentional retinal artery amputation during macular peeling
1Department of Ophthalmology, Fujita Health University Bantane Hospital, Aichi, Japan.
GMS Ophthalmology Cases
|April 10, 2020
Summary
Unintentional retinal artery amputation occurred during macular peeling surgery in a patient with staphyloma. Careful technique and minimizing triamcinolone (TA) are crucial to prevent vessel damage during this challenging procedure.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Epiretinal membrane (ERM) surgery involves macular peeling.
- Severe staphyloma presents unique surgical challenges due to altered retinal anatomy.
Observation:
- A case of unintentional retinal artery avulsion during ERM peeling in a patient with severe staphyloma.
- Triamcinolone (TA) staining enhanced visualization but obscured retinal texture, contributing to the complication.
Findings:
- The inferior temporal retinal artery branch was amputated during peeling.
- Postoperative complications included vitreous hemorrhage and superior nasal visual field loss.
- The patient perceived the damaged vessel as a visual floater.
Implications:
- Macular peeling requires meticulous attention to avoid vascular damage, especially in eyes with staphyloma.
- Excessive triamcinolone (TA) should be removed before peeling to ensure clear visualization of retinal structures.
- Altered anatomy in staphyloma increases risk of vessel injury during vitreoretinal surgery.
