Venous-air embolism during vitrectomy for endoresection of choroidal melanoma: Case report.

INTRODUCTION: The purpose of this study is to report a case of venous-air embolism during a vitrectomy for endoresection of choroidal melanoma. CASE DESCRIPTION: A 31-year-old man went to the clinic because of photopsias and vision loss in his right eye. On fundoscopy of the right eye, a choroidal mass with an associated retinal detachment was found near the inferotemporal vascular arcade. Multimodal imaging was performed and diagnosis of choroidal melanoma was made. Metastatic workup ruled out systemic extension. The patient underwent pars plana vitrectomy for endoresection of the lesion. During the application of laser under air, he started complaining of chest pain and dyspnea. He presented signs of supraventricular tachycardia, tachypnea, hypotension and oxygen desaturation. He was managed with orotracheal intubation, bronchodilators and vasopressor support, and stabilization was achieved. He was discharged 2 days after with no sequalae. After 1-year of follow-up, the patient has a visual acuity of counting fingers and no signs of tumor recurrence or systemic extension. CONCLUSIONS: Although rare, vitreoretinal surgeons should be aware of this potentially fatal complication and take steps to prevent it.

Retinopathy of prematurity: incidence report of outliers based on international screening guidelines.

AIM: The objective of this study is to report the incidence of retinopathy of prematurity (ROP) outliers that fall outside the screening guidelines of the American Academy of Ophthalmology (AAO) in our country. METHODS: A retrospective review of 503 records of newborns evaluated in our institution between January 2011 and March 2017. We analyzed the data by subgroups based on gestational age (GA), birth weight (BW) and stage, focusing on the outliers that don't meet the criteria of the screening AAO guidelines (GA ≤ 30 weeks, BW ≤ 1500 g). RESULTS: Of the 503 records, 352 had some degree of ROP, 91.76% being bilateral, and 26.2% require treatment. The mean GA at delivery was 30.56 ± 2.33 weeks, and the mean BW was 1287.90 ± 338.52 g. For the current AAO/AAP ROP screening, 19.9% were outliers, of which (57%) had ROP diagnosis and (38%) required treatment. CONCLUSIONS: ROP diagnosis in newborns of BW > 1500 g or GA > 30 weeks is not uncommon in Mexico, and it is important to take this into account to adjust the selection criteria on each population to reach all the infants at risk.