Background. Ocular vascular occlusions following intraocular procedures are a
rare complication. We report a case series of patients with retinal vascular
occlusions or anterior ischemic optic neuropathy (AION) after anterior and
posterior segment surgery and demonstrate possible risk factors. Methods.
Observational case series. Results. In ten patients, vascular occlusions were
observed within ten weeks after intraocular surgery: branch retinal arterial
occlusion (BRAO) (n = 2), central retinal artery occlusion (CRAO) (n = 2),
central retinal vein occlusion (CRVO) (n = 1), branch retinal vein occlusion
(BRVO) (n = 1), anterior ischemic optic neuropathy (AION) (n = 3), and
combined central artery and vein occlusion (n = 1). AION occurred later (27–69
d) than arterial occlusions (14–60 d) or venous occlusions (1-2 d). In all
cases, either specific surgical manipulations or general vascular disorders
were identified as risk factors. In addition to general cardiovascular risk
factors (arterial hypertension n = 6, diabetes mellitus n = 4), internal
workup disclosed bilateral stenosis of the carotid arteries (n = 1) and
myeloproliferative syndrome (n = 1). Conclusion. Vascular occlusions after
surgical ocular procedures seem to be more frequent when cardiovascular
diseases coexist. Surgical maneuvers and intra- or postoperative pressure
changes may act as a triggering mechanism in patients with underlying systemic
cardiovascular disorders. Affected patients should undergo thorough internal
examination to identify possible underlying diseases