J Korean Ophthalmol Soc.  2009 Jun;50(6):942-945. 10.3341/jkos.2009.50.6.942.

Ulnar Neuropathy as a Complication of Retinal Detachment Surgery

• Sun HJ
• Baek SC
• Choi KS
• Lee SJ

• KMID: 2212375
• DOI: http://doi.org/10.3341/jkos.2009.50.6.942

Abstract

PURPOSE: To report a case of ulnar neuropathy as an extraocular complication following retinal detachment surgery and face-down positioning.
CASE SUMMARY
A 65-year-old woman was referred to our hospital with decreased visual acuity in the left eye. Fundus examination revealed a rhegmatogenous retinal detachment not involving the macula in the left eye. A vitrectomy with scleral encircling and 18% SF6 gas tamponade was performed. The patient was instructed to assume a face-down position. After 5 days, the patient reported having paresthesia and numbness of the left 4th and 5th fingers. Neurologic exams were performed and the results indicated ulnar neuropathy. There was no improvement in the neurologic symptoms during the 6-month follow-up.
CONCLUSIONS
Surgeons performing retinal surgery should caution their patients of ulnar neuropathy when face-down positioning is required. The patients should be instructed to minimize the time spent with their elbows flexed in a stationary position. Additionally, the pressure loaded on the bent elbow should be minimized.

Keyword

Face-down positioning; Gas tamponade; Retinal detachment; Ulnar neuropathy; Vitrectomy

MeSH Terms

Aged
Elbow
Eye
Female
Fingers
Follow-Up Studies
Humans
Hypesthesia
Neurologic Manifestations
Paresthesia
Retinal Detachment
Retinaldehyde
Ulnar Neuropathies
Visual Acuity
Vitrectomy
Retinaldehyde

Figure

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  Figure 1. Body position of the patient. The patient spent most of the time with her arms flexed, applying pressure on the bent elbows. Sitting (A), bowing down (B), and lying on her stomach (C, D).

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  Figure 2. Neurophysiologic test of the right (A) and left (B) ulnar nerve. The evoked muscle action potential in the left ulnar nerve with stimulation proximal to the elbow (solid arrow) was less than 50% of the potential obtained with stimulation of the wrist (dotted arrow). The finding was consistent with sustained compression injury of the left ulnar nerve.

Reference

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