“Central retinal artery occlusion following scleral buckling surgery with gas insertion in a patient with sickle cell disease”

Purpose- To describe a case of central retinal artery occlusion following scleral buckling procedure combined with pneumoretinopexy in a patient with sickle cell (HbSC) retinopathy (SCR). Methods- Scleral buckling procedure, combined with injection of 0.3 ml of 100% perfluoropropane (C3F8) gas in the vitreous, was performed without intra-operative complications under general anaesthesia as treatment of two separate macula-sparing rhegmatogenous retinal detachments secondary to round holes, involving superior and inferior retina respectively, in the right eye of a 26-year-old Afro-Caribbean female with sickle cell disease. Results- On day one post-operatively, central retinal artery occlusion (CRAO) was detected in the operated eye. We hypothesize that the expansion of the gas in the postoperative period combined with the presence of a retinal explant might have caused a moderate elevation of the IOP that caused extensive retinal arteriolar shutdown in the backdrop of SCR. Conclusion- CRAO can be a devastating complication following scleral buckling procedure combined with gas insertion in SCR, caution is required when performing scleral explant combined with expansile gas in a patient with sickle cell vasculopathy.