CENTRAL RETINAL ARTERY OCCLUSION AFTER SCLERAL BUCKLING SURGERY WITH GAS INSERTION IN A PATIENT WITH SICKLE CELL DISEASE.

PURPOSE: To describe a case of central retinal artery occlusion after scleral buckling procedure combined with pneumoretinopexy in a patient with sickle cell (hemoglobin SC) retinopathy.

METHODS

Scleral buckling procedure, combined with injection of 0.3 mL of 100% perfluoropropane gas in the vitreous, was performed without intraoperative complications under general anesthesia as treatment of two separate macula-sparing rhegmatogenous retinal detachments secondary to round holes, involving superior and inferior retina, respectively, in the right eye of a 26-year-old Afro-Caribbean woman with sickle cell disease.

RESULTS

On day 1 postoperatively, central retinal artery occlusion was detected in the operated eye. We hypothesize that the expansion of the gas in the postoperative period combined with the presence of a retinal explant might have caused a moderate elevation of the intraocular pressure that caused extensive retinal arteriolar shutdown in the backdrop of sickle cell retinopathy.

CONCLUSION

Central retinal artery occlusion can be a devastating complication after scleral buckling procedure combined with gas insertion in sickle cell retinopathy, caution is required when performing scleral explant combined with expansile gas in a patient with sickle cell vasculopathy.