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AbstractP 059 Acute bilateral detachment of the central neurosensory retina after unilateral anterior chamber intervention Schöpfer K., Sekundo W., Stoffelns B. M., Pfeiffer N.
Department of Ophthalmology, Johannes-Gutenberg University, Mainz Objective: Bilateral detachments of the central neurosensory retina are often attributed to degenerative macula changes or general illness. We report on a 50-year-old male patient with a bilateral detachment of the central neurosensory retina after an intraocular lens-refixation (IOL) of a dislocated IOL.
Results: The patient was admitted to our hospital because of an IOL-luxation with vitreous prolapse in the left better eye with a visual acuity of 0.5. We performed an anterior vitrectomy and suture re-fixation of the dislocated IOL at the iris. The patient was started on a perioperative systemic antibiotic treatment with cefadroxil 1g 3x/d (Grüncef®) because of a longstanding severe neurodermatitis. Both eyes were pseudophakic, the right eye suffering from a keratoconus had a history of a failed corneal graft. Retinal changes were not present. On the second postoperative day there was a moderate anterior chamber flair and the patient reported an increasing grey veil. There was seen a central retinal elevation at the operated eye. The fluorescein angiography showed a sharply defined, wide hyperfluorescence in the macula region. The OCT of both eyes was positive for an elevation of the neurosensory retina. He was treated with subconjunctival steroid-injections (dexamethasone 4 mg) and prednisolone acetate 150 mg orally. All laboratory parameters were within normal limits. A complete normalization of the ocular findings occurred within 2 weeks under systemic steroid treatment.
Conclusions: Because of the neurosensory retinal detachment in both eyes after a unilateral IOL-refixation, a systemic factor must be considered. There might be some links between the oral intake of first generation cephalosporine and a bilateral detachment of the neurosensory retina as reported.
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