Scleral windows for exudative retinal detachment in nanophthalmos

Nanophthalmic eyes are associated with increased scleral thickness, decreased uveoscleral outflow, and increased incidence of uveal effusion syndrome, exudative retinal detachment, and angle closure glaucoma. Lamellar sclerectomies can enhance uveoscleral permeability. We report a case of nanophthalmos with exudative retinal detachment, submitted to anterior lamellar sclerectomies. A 50-year-old male patient presented with high hyperopia who complained of progressive visual loss in the right eye. The best-corrected visual acuity was 20/400 in both eyes; fundoscopy showed peripheral choroidal detachments in both eyes and retinal detachment in the right eye. Ocular ultrasound revealed thickened scleral walls and short axial lengths in both eyes. Fluorescein angiography confirmed an exudative retinal detachment in the right eye. Two inferior lamellar sclerectomies were performed in the right eye. Postoperative period was uneventful; subretinal fluid was progressively reabsorbed with retinal reattachment.