Acute serous detachment of retina after surgery in prone position
DOI:
https://doi.org/10.21615/cesmedicina.34.3.5Keywords:
Retinal detachment, Prone position, Minor surgical procedures, Transient blindness, ComplicationsAbstract
Prone position is used in surgery to access different anatomical structures of the patient. This position can be associated with postoperative visual loss in 0.05 to 1 % of complications. Serous retinal detachment is the separation of the neurosensory retina from the retinal pigment epithelium by fluid accumulation without structural damage. This is the result of changes in the permeability and perfusion of the choroid. This is the case of a woman with an indication for removal of a bilateral gluteal prosthesis by surgery in the prone position. A displacement of the cushion positioned on the face was identified and the headboard did not correspond to the bone structure of the patient. In the recovery room, the patient reported visual loss in the left eye, which was immediately evaluated by Ophthalmology, finding a normal bilateral intraocular pressure. The left eye fundus examination revealed multiple areas of retinal detachment. Optical coherence tomography confirmed the presence of subretinal fluid. She was treated with topical nepafenac and prednisolone, and evaluated at 72 hours and a week, with total resolution of the condition and corrected visual acuity of 20/20. There are no reports in the literature of serous retinal detachment after prone surgery. When evaluating the case, it was assumed that the incorrect position of the cushion and the inadequate size of the bedside are factors that could have contributed to venous stasis of the choroidal flow, suddenly increasing the hydrostatic pressure in the choroid that caused the serous retinal detachment.
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