Emphysema following vitrectomy with fluid–gas exchange: description of a rare complication
A 55-year-old man presented with bilateral eyelid and face edema, dysphagia, dysphonic voice, and mild dyspnea 30 minutes after a 23-gauge vitrectomy surgery with fluid–gas exchange. A slit-lamp examination presented with bilateral eyelid edema. A single X-ray image of the thorax and neck also confirmed the semiologic aspects ( and ). The air infiltration of the soft tissue demonstrated crepitating of the soft tissue to digital press on the face, extending to the neck and upper chest. The patient underwent an orbital computed tomography scan that revealed the presence of emphysema of the orbit and bilateral soft tissue on the face ().\nThe patient had a past history of face trauma for more than 20 years, with orbital fracture of the floor. This fracture was not previously correct by surgery and is considered as a scar nowadays ().\nThe patient was hospitalized for clinic observation, cardiac evaluation, blood testing, and prophylactic antibiotic therapy for one week. All signs of compressed anatomical structures by subcutaneous emphysema (dysphagia, dyspnea, and dysphonia) had ceased at the time of discharge, and the patient was in improved and stable condition. Postoperatively, at 3 months, the retina was flat with good intraocular pressure (IOP) control and no evidence of orbital infection.