Posterior Wall Collapse in High Myopia following Cataract Surgery

• Published in: Case reports in ophthalmology Vol. 9; no. 1; pp. 167 - 171
• Main Authors: Deitz, Galia A., Sweeney, Adam R., Jung, Hoon C.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01-01-2018; Karger Publishers
• Subjects: Case Report; Case reports; Cataract surgery; Cataracts; Contact lenses; Eye surgery; Glaucoma; High myopia; Hypotony; Ophthalmology; Suture removal; New York; Puget Sound; United States > US; Baltimore Maryland; Cataract surgery; High myopia; Hypotony; Suture removal
• ISSN: 1663-2699; 1663-2699
• DOI: 10.1159/000487077

Purpose: We report a case of posterior globe collapse of an eye after initial recovery from uncomplicated cataract surgery in a patient with high myopia and discuss the course of management involving recognition and emergent air injection with globe reformation. Case Report: A 64-year-old functionally monocular male with a history of high myopia presented for follow-up after uncomplicated cataract surgery. Uncorrected distance visual acuity (UCDVA) at postoperative day 1 was 20/150 with an intraocular pressure (IOP) of 19 mm Hg. At the week 1 visit, UCDVA had decreased to 20/200 with an IOP at 9 mm Hg. After preliminary exam, the keratome site suture was removed, after which the patient reported vision changes. A dilated fundus exam was performed revealing posterior scleral wall collapse. A clinical diagnosis of hypotony was made and a pars plana injection of 1 mL air was performed. This resulted in immediate subjective improvement of vision. Exam the next day revealed UCDVA 20/50 with pinhole improvement to 20/30 and IOP 15 mm Hg. Conclusion: This case demonstrates postoperative hypotony in a patient with pathologic myopia, following cataract surgery. Pathologically myopic eyes may have greater propensity to collapse in the setting of reduced IOP.