Massive Exudative Retinal Detachment Following Photodynamic Therapy and Intravitreal Bevacizumab Injection in Retinal Capillary Hemangioma

ment was recommended, but the patient initially refused. As the clinical findings did not change during follow-up, surgery was performed in August 2014. Restriction of the inferior rectus muscle of the left eye was confirmed through the forced duction test. During surgery, conjunctival scarring over the inferior rectus muscle was noted, in addition to a linear scar along the medial border of the muscle. The inferior rectus muscle of the left eye was recessed by 5 mm and the superior rectus muscle of the right eye was recessed by 5 mm. The postoperative ocular alignment showed orthotropia, and the patient achieved binocular single vision (Fig. 1). STA is becoming increasingly popular because it provides good analgesia without the passage of sharp needles in the orbit. The reported complications of STA include subconjunctival hemorrhage, chemosis, extraocular muscle paresis, and optic neuropathy [2,3]. Postoperative diplopia following cataract surgery under STA is particularly disconcerting for the surgeon. Jaycock et al reported three cases of persistent rectus muscle restriction after STA [4]. They postulated that direct trauma to the muscle with hematoma formation occurred at the time of the STA with subsequent contracture of the affected muscle. We agree with their hypothesis based on our surgical f indings. Although inferior rectus muscle restriction after STA is uncommon, the surgeon needs to be aware of this possibility; care must always be taken to avoid direct trauma to the muscle during the procedure. Won Jae Kim, Myung Mi Kim Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea E-mail: [email protected]