A 74-year-old woman with type II diabetes of 15 years duration, treated with oral hypoglycemic agents, who presented with decreased visual acuity.
Extra cataract surgery was performed not in 1992 in right eye (OD) and in 2001 in left eye (LE) with anterior chamber lens of polymethylmethacrylate and full capsule without using an IOL.
Functional fixation presents a visual acuity (VA) of 0.6 in RE and 0.2 in LE, applanation ocular pressure (IOP) of 14 and 15 mm Hg, respectively.
In biomycosis, the right eye presents intraocular lens (IOL) in the anterior chamber (AC) with no further alterations.
In the anterior pole of the left eye, an IOL was observed in the AC, with a posterior capsule opacity of ++, the rest without alterations.
YAG-LASER capsulotomy was performed in the left eye with a power of 5.2 mJ (31 shots).
A 2 x 2 mm circular capsulotomy was created. Three days after treatment the VA was 0.7 in the RE and 0.5 in the LE, anterior pole and posterior pole without alterations.
Thirteen days after capsulotomy, the patient reported a sudden decrease in visual acuity of the left eye.
The physical examination revealed a 3 mmHg IOP, a circular capsulotomy, anterior pole with signs of inflammation, with posterior vitreous pigment projecting the IOL towards the face.
Posterior pole with choroidal detachment (CD) with superior nasal and temporal pockets, without touch between them, rhegmatogenous detachment of the retina from the meridian region of the IX to the II macular lesion.
Documented by ultrasound with an ocular axial length of 23.12 mm.
The treatment of choroidal detachment was initiated with prednisone 1.5 mg/kg/day orally and injected into sub-Tenon's space 2.71 mg of beta-metasone acetate, Mexicoughlo sodium beta-metasone 3.0 mg.
At 14 days, an IOP of 8 mmHg and a slight decrease in CD size were observed, so a second dose of 2.71 mg of betamethasone acetate and 3.0 mg of sodium phosphate was administered.
Silicon detachment or left silicone resection showed less inflammation in the choroidal detachment unresolved with conventional treatment, in addition to retinal detachment, so it was decided to perform a surgical intervention.
Three months after surgery, the patient had a CD VA of 50 cm, IOP of 9 mmHg, middle mydriasis, IOL in the anterior pole, retina applied with areas of fibrosis without traction and silicone.
