Branch Retinal Vein Occlusion after Cataract Surgery: A Case Report

Abstract

Aim: This study aims to present a rare case of branch retinal vein occlusion (BRVO) that developed after cataract surgery and to evaluate possible preoperative and intraoperative risk factors. Background: Cataract surgery is one of the most frequently performed ophthalmic surgical procedures worldwide, generally associated with favorable outcomes. However, as with all surgeries, complications may occur, including rare retinal vascular occlusions such as BRVO. Case Presentation: A 62-year-old male with hypertension but no other systemic comorbidities underwent right-eye phacoemulsification and intraocular lens implantation for grade 4 nuclear cortical cataract. The surgery was prolonged due to poor pupillary dilation and dense lens nucleus, requiring high phacoemulsification energy and elevated intraocular pressure (IOP) settings. One week postoperatively, fundus examination revealed BRVO in the superior temporal quadrant, confirmed with fluorescein angiography (FA) and optical coherence tomography (OCT), which also demonstrated cystoid macular edema. The patient received three monthly intravitreal injections of aflibercept (2 mg/0.05 mL), resulting in complete resolution of macular edema and improvement in visual acuity from 20/200 to 20/40. Conclusion: Although rare, BRVO may develop after cataract surgery, particularly in patients with hypertensive retinopathy and intraoperative conditions that cause fluctuations in IOP. Awareness of these risk factors and careful perioperative management may help reduce the risk of such complications.