Retinal Pigment Epithelium Tear After Nonpenetrating Deep Sclerectomy

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Retinal Diseases

Background:

• Retinal pigment epithelium (RPE) tears are known complications of neovascular age-related macular degeneration treated with anti-VEGF therapy.
• While RPE tears have been reported after trabeculectomy, they have not been documented following nonpenetrating deep sclerectomy (NPDS).

Observation:

• A 57-year-old male with advanced, uncontrolled glaucoma underwent NPDS with mitomycin C in his left eye.
• Postoperatively, on day seven, clinical examination and multimodal imaging confirmed a macular RPE tear in the operated eye.

Findings:

• The RPE tear led to the development of subretinal fluid.
• The subretinal fluid resolved within two months, accompanied by an increase in intraocular pressure.

Implications:

• This case represents the first documented instance of an RPE tear occurring subsequent to NPDS.
• The findings suggest a potential, albeit rare, risk of RPE tears following NPDS, necessitating further investigation and awareness.