First Author: C.Menezes PORTUGAL
Co Author(s): J.A. Lemos R. Gonçalves P. Coelho J. Serino B. Cardoso Vieira R. Carvalho 0 0 0 0 0 0 0 0 0
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To report a clinical case of photic retinopathy in the context of cataract surgery
Department of Ophthalmology - Hospital Pedro Hispano, Matosinhos, Portugal
Clinical case report.
Microscope induced photic retinopathy (MIPO) has been correlated with UV-blue light exposure, being the primary locals of photochemical damage the complex RPE-photoreceptors. Past MIPO rates were reported to be as high as 7%, but are less frequent now because of new and safer microscopes and improved and faster cataract surgery techniques. A 77-year-old woman with antecedents of hypertension was proposed for OD cataract phacoemulsification due to a mild corticonuclear cataract. Best corrected visual acuity (BCVA) was 5/10 and the ophthalmological exam, apart from the cataract, was otherwise normal. The surgery lasted 25 minutes and underwent without complications. Three weeks later, the BCVA was 8/10 with -1,00x100º. The patient was satisfied but referred mild central visual field distortion. The ocular examination was normal, with the exception of a round, one disc diameter, macular lesion with RPE atrophy and variable pigment mottling, best appreciated in fluorescein angiography. The latter and the OCT also confirmed the presence of a mild macular edema, which resolved in 6 weeks with the aid of bromfenac bid. A residual scar with severe irregularity of the RPE subsisted. BCVA improved to 10/10 and is still stable 10 months after surgery.
Despite the development of new and safer illumination surgical devices in recent years, the potential for retinal damage from microscope light illumination exists, even in uncomplicated and short-duration surgeries.