2Ophthalmologist, Antalya Training and Research Hospital, Ophthalmology Department, Antalya, Turkey DOI : 10.37845/ret.vit.2020.29.25 We report a case report of a 55-year old man who developed an unexpected complication after 23-gauge pars plana vitrectomy (PPV) with perfl uoropropane (C3F8) gas tamponade for the full thickness macular hole (MH).
On postoperative day 3, he presented with vision loss, severe pain in his operated eye. His examination revealed edema in the lower and upper lid, proptosis, gas expansion in fundus and increased intraocular pressure (IOP). Computed tomography demonstrated gas migration into the subconjuctival and retrobulber areas. As orbital compartment syndrome (OCS) was thought to have developed, gas aspiration from the subtenon space and vitrectomy with gas to fl uid exchange were performed. All symptoms resolved after the removal of the gas. However, visual acuity could not improve further than fi nger counting from 1 meter distance during his follow up since optical atrophy developed.
Surgeons should be careful while adjusting the concentration of intraocular gas application, while patients for whom gas was applied should be closely followed after surgery.
Keywords : Macular hole, Pars plana vitrectomy, Perfl uoropropane, Proptosis, Orbital compartment syndrome