Ocular Decompression Retinopathy During Pars Plana Vitrectomy Without Pre-Existing Ocular Hypertension: A Case Report

To report a case of ocular decompression retinopathy that developed during pars plana vitrectomy in the absence of pre-existing ocular hypertension.

An 84-year-old male patient was referred to our hospital following complicated phacoemulsification for cataract surgery involving a posterior capsular rupture. As a result, 25G+ pars plana vitrectomy was performed along with cortical remnant removal, iridodialysis repair, and intraocular lens (IOL) implantation. During surgery, ocular deformation occurred, accompanied by iris prolapse and acute hypotony due to abrupt intraocular pressure (IOP) fluctuations linked to infusion pressure changes during IOL implantation. Multiple intraretinal hemorrhages, including peripapillary hemorrhages and those over the posterior pole and equator, were observed. Optical coherence tomography performed on the following days confirmed the presence of hemorrhages identified during the intraoperative period at different retinal levels.

Ocular decompression retinopathy can occur after various ocular surgeries, especially those associated with intraoperative IOP changes. Intraocular pressure control maneuvers and maintenance of ocular tone are crucial for the success of any surgical procedure.