Sympathetic ophthalmia risk following vitrectomy: should we counsel patients?

Retinal surgery is being performed with increasing frequency as the advent of newer microsurgical techniques, perfluorocarbon liquids, and silicone oil tamponade has produced greater anatomical and functional success in preserving vision for both primary and repeat retinal surgery.1 With the ageing of the population, and associated increased incidence of retinal detachment and age related macular degeneration, pars plana vitrectomy, in particular, is being increasingly performed with expanding indications, such as for phakic retinal detachment repair, macular hole, submacular and retinal translocation surgery.1 2Sympathetic ophthalmia is a rare disease, with an incidence of 0.03/100 000,3 causing bilateral severe posterior uveitis following penetrating trauma to one eye. Sympathetic ophthalmia has potentially devastating visual consequences if treatment is delayed or inadequate, and usually chronic immunosuppressive therapy is required in order to preserve good vision.4 Formerly, accidental penetrating eye trauma was the main cause but ocular surgery, particularly retinal surgery, has now become the main risk for sympathetic ophthalmia.3 4

The eye is regarded as an …