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Postvitrectomy positioning complicated by ulnar nerve palsy
T A Ciulla1, A R Frederick, C Kelly
1Department of Ophthalmology, Indiana University School of Medicine, Boston, MA, USA.
American Journal of Ophthalmology
|November 1, 1996
Summary
Ulnar nerve palsy can occur after vitrectomy if patients maintain a face-down position. Avoiding prolonged elbow pressure or flexion can help prevent or resolve this complication.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Postvitrectomy positioning is crucial for surgical success.
- Ulnar nerve palsy is a rare but potential complication.
Observation:
- Two cases of ulnar nerve palsy following vitrectomy with face-down positioning are presented.
- Patients maintained face-down positions for 2-4 weeks after surgery.
Findings:
- Ulnar nerve palsy developed in both patients.
- One patient improved with conservative management (avoiding elbow pressure/flexion).
- The other patient required surgical decompression for persistent symptoms.
Implications:
- Prolonged face-down positioning after vitrectomy can lead to ulnar nerve palsy.
- Direct pressure or sustained elbow flexion are likely mechanisms.
- Awareness and preventative measures are important for ophthalmologists and patients.