Occurrence and surgical management of a cerebrospinal fluid-filled cystoid space following routine enucleation. Ophthalmic Plast Reconstr Surg 2012;28(5):e117-8
Date
03/01/2012Pubmed ID
22366667DOI
10.1097/IOP.0b013e318242ab62Scopus ID
2-s2.0-84866335079 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
A 73-year-old woman underwent routine enucleation for a blind, painful eye related to end-stage diabetic retinopathy and neovascular glaucoma. A large cystoid space, in continuity with the optic nerve stump, formed around the implant in the first few weeks following surgery. Aspirated contents were positive for β-2 transferrin, confirming cerebrospinal fluid origin. Multiple comorbidities delayed surgical intervention, but the condition was ultimately managed with exposure of the patent optic nerve sheath at the compartment's base, temporary control of cerebrospinal fluid leakage with pulmonary hyperventilation and topical fibrin glue, dissection and vascular-clip ligation of the nerve stump, and capping with a dermis-fat graft. To the authors' knowledge, this postenucleation entity has not been previously described, and asymptomatic idiopathic intracranial hypertension may have been an underlying factor.
Author List
Elmalem VI, Harris GJAuthor
Gerald J. Harris MD Professor in the Ophthalmology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedCerebrospinal Fluid
Cysts
Diabetic Retinopathy
Eye Enucleation
Female
Glaucoma, Neovascular
Humans
Ophthalmologic Surgical Procedures
Orbital Diseases
Postoperative Complications
Tomography, X-Ray Computed
Transferrin
