Suprachoroidal gas injection as a complication of pars plana vitrectomy confirmed by computed tomography

Abstract

Akihito UjiDepartment of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, JapanBackground: Suprachoroidal gas injection has been reported as a complication of pneumatic retinopexy, and the usefulness of B-scan ultrasonography has been reported. A case of suprachoroidal gas injection as a complication of pars plana vitrectomy confirmed by computed tomography (CT) is presented here.Methods: A 64-year-old woman developed a vitreous hemorrhage due to a retinal tear secondary to an old branch retinal vein occlusion. A 23-gauge pars plana vitrectomy was performed. Sclerotomies were performed at a 30° angle. After air–fluid exchange, sulfur hexafluoride gas was injected through a temporo-superior sutured sclerotomy with direct visualization of the entire needle tip. Postoperatively, a large choroidal elevation was identified temporo-superiorly with intravitreal gas, and the patient complained of a mild headache.Results: On postoperative Day 7, a CT scan showed two low-density areas, confirming the presence of suprachoroidal gas; intravitreal gas blocked visualization of the suprachoroidal gas on B-scan ultrasonography. On postoperative Day 14, the intravitreal gas resolved and a CT scan showed a small amount of residual suprachoroidal gas. By this time, the headache had completely resolved.Conclusion: Suprachoroidal gas injection is a rare complication of pars plana vitrectomy that resolves spontaneously. In this case, CT scans confirmed the presence of suprachoroidal gas despite the presence of intravitreal gas.Keywords: suprachoroidal gas, complication, pars plana vitrectomy, computed tomography