ABSTRACT NUMBER - 6

ACUTE INTRAOPERATIVE ROCKHARD EYE SYNDROME – REPORT OF A NEWLY RECOGNISED SYNDROME AND ITS MANAGEMENT IN SIX CASES


Oliver Lau, Jessica Montfort, Sai Win, Benjamin Sim, Olivia Fox, Michael Wei, Ashima Aggarwala, Claire Ruan, Gaurav Bhardwaj, Ravjit Singh, Allan Bank, Minas Coroneo, Ashish Agar, Ian Francis

Meeting:  2012 RANZCO


SESSION INFORMATION

Date:      -

Session Title: POSTER ABSTRACTS

Session Time:      -

Purpose:
To describe a newly recognised entity, the Acute Intraoperative Rockhard Eye Syndrome (AIRES), and its management in six cases. AIRES is character-ised by anterior chamber (AC) shallowing and an acute, marked intraocular pressure (IOP) increase during phacoemulsification cataract surgery, preclud-ing further surgery, but with no evidence of choroidal haemorrhage.

Method:
Prospective, consecutive, non-comparative, interventional case series of phacoemulsification cataract surgery. Management was with emergent intraoperative pars plana needle aspiration (PPNA) of retrolenticular fluid with a 23-gauge needle attached to a 3 mL syringe. Follow-up was at 1 day, 1 week and 1 month. Resolution of AIRES, posterior segment integrity, and corrected distance visual acuity (CDVA) were documented.

Results:
Six patients with AIRES were identified in 298 cases. Mean age was 81 years; all were female with nuclear cataracts of grade 2–4 (LOCS II). In each case, PPNA successfully and immediately normalised AC depth and IOP, and completion of surgery proceeded uneventfully. Follow-up was 100%. Postoperative fundoscopy revealed transient mild vitreous haemor-rhage in one patient; new posterior vitreous detach-ment in one patient; and localised vitreous syneresis in three patients. CDVA in 5 of 6 patients was 6/4 at 1 month.

Conclusion:
AIRES presents with AC shallowing and marked IOP elevation during cataract surgery, occur-ring in 2% of cases in this series. PPNA effectively resolved each case immediately and was not associated with any significant complications.

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