Sympathetic ophthalmia following vitrectomy and/or retinal detachment surgery
Inouye, S.; Ideta, H.; Ishikawa, M.; Yoshino, Y.
Nippon Ganka Gakkai Zasshi 92(3): 372-376
1988
ISSN/ISBN: 0029-0203 PMID: 3046261 Document Number: 318216
Between 1978 and 1986, 5 cases of sympathetic ophthalmia after vitrectomy or retinal detachment surgery were diagnosed. Four of these cases occurred after both vitrectomy and retinal detachment surgery. One patient had received only retinal detachment surgery. Among the 402 cases of vitrectomy performed at our hospital, the incidence of sympathetic ophthalmia was 0.97%. Among the 1362 cases of retinal detachment surgery the incidence of sympathetic ophthalmia was 0.37%. The clinical course and the HLA of these 5 cases were examined. Three of the patients were males and two were females. Their ages ranged from 27 to 66 years and averaged 40 years. Their primary disease was retinal detachment in four patients and lens subluxation in one patient. Four of these patients were treated with 3-port pars plana vitrectomy and scleral buckling. One case was treated with scleral buckling and trabeculectomy. All cases were difficult to treat and underwent multiple operation upon repeatedly. Sympathetic ophthalmia did not occur in any patient after a single vitrectomy or after retinal detachment surgery. HLA for five cases were positive to HLB-Bw and DR4. This was consistent with previously published reports. Between 3 weeks and 9 months after vitrectomy and retinal detachment surgery, attention must be given to the prodromal symptoms and diagnosis and treatment must be performed as rapidly as possible.