Case Report: Acute Retinal Necrosis following Unexpanded Gas Tamponade Acute Retinal Necrosis following Unexpanded Gas Tamponade

Purpose: To present 2 cases of acute non-hemorrhagic retinal necrosis occurring following pars plana vitrectomy for epiretinal membrane peeling following the use of unexpanded gas tamponade.Case Report: Two eyes (both right eyes) of 2 healthy females presented with decreased visual acuity due to Epiretinal membrane, and they underwent 25G vitrectomy and membrane peeling. The vitrectomy operation was uneventful and was concluded with the insertion of 20% sulfur hexafluoride (SF6) tamponade. Both eyes were pseudophakic and had no other ocular or systemic pathology. Patients were controlled 24 hours following the surgery and both presented with normal anterior segment examination and normal intraocular pressure. Both patients complained of central scotoma and both had very difficult light perception. Fundus examination showed devitalized macula structures in the presence of gas bubbles occupying almost 100% of the vitreous cavity. OCT examination done a few days after surgery revealed necrotic retinal tissue. Four weeks later, both eyes had light perception vision, and devitalization of the central macula and spicule-like pigment changes in the midperiphery of the retinal in both eyes.Conclusion: We present 2 cases of blindness after vitrectomy with ILM peeling combined with 20% SF6 Intraocular tamponade. This severe complication was not related to elevated intraocular pressure due to gas expansion.