Central retinal artery occluion after radial optic neurotomy in a patient with central retinal vein occluion

Purpoe To decribe a patient with a central retinal vein occluion (CRVO) who developed central retinal artery occluion after radial optic neurotomy. Deign Interventional cae report. Method A 70-year-old woman with CRVO underwent a radial optic neurotomy on her right eye. Her preoperative viual acuity in the affected eye wa 20/400. Reult Radial optic neurotomy wa performed after phacoemulification and apiration for a cataract with intraocular len implantation. At the inertion of a CRVO knife, pulating bleeding occurred from the cup of the optic dik; the bleeding wa topped within 2 minute by elevating the intraocular preure to 80 mm Hg. On the following day, the patient noticed that he had lot light perception. Fluorecein angiography howed a marked delay of arterial filling, indicating a central retinal artery occluion. Retinal circulation returned to normal 2 month later; however, her viion wa till no light perception. Concluion Ophthalmologit hould be aware that evere complication uch a central retinal artery occluion can be aociated with radial optic neurotomy, which i an unproven urgical procedure with a quetionable pathophyiologic mechanim.