Postoperative vision loss due to bilateral vitreous hemorrhage after robot-assisted laparoscopic hysterectomy: A case report

Yuka Numaga; Fumiyuki Araki; Kunihiro Azuma; Taku Toyama; Koichiro Sugimoto; Tomoyasu Shiraya; Takashi Ueta

doi:10.1016/j.ajoc.2023.101985

Postoperative vision loss due to bilateral vitreous hemorrhage after robot-assisted laparoscopic hysterectomy: A case report

Am J Ophthalmol Case Rep. 2023 Dec 26:33:101985. doi: 10.1016/j.ajoc.2023.101985. eCollection 2024 Mar.

Authors

Yuka Numaga¹, Fumiyuki Araki¹, Kunihiro Azuma¹, Taku Toyama¹, Koichiro Sugimoto¹, Tomoyasu Shiraya^{1

2}, Takashi Ueta¹

Affiliations

¹ Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
² Eye Center, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, 187-8510, Japan.

Abstract

Purpose: To report a case of bilateral vitreous hemorrhage (VH) resulting in postoperative vision loss (POVL) after robot-assisted laparoscopic hysterectomy in a 71-year-old female patient.

Observations: At initial presentation, best-corrected visual acuity was hand motion at 20 cm in the right eye and 20/666 in the left eye. VH in both eyes and preretinal hemorrhage in the left eye was observed. As the hemorrhage gradually resolved, a full-thickness macular hole was discovered in the right eye, for which the patient did not agree with a surgical treatment.

Conclusions and importance: This report describes a rare incidence of bilateral VH as a cause of POVL after non-ophthalmic surgery, which may be related to Trendelenburg positioning, CO2 pneumoperitoneum, and a long surgical duration. Given that POVL can cause severe visual impairment, consultation with ophthalmologists is crucial.

Keywords: Peumoperitoneum; Postoperative vision loss; Preretinal hemorrhage; Robot-assisted surgery; Trendelenburg position; Vitreous hemorrhage.

Publication types

Case Reports