Delayed rhegmatogenous retinal detachment following high-voltage electrical injury: a case report

Background: Electric cataract is a recognized complication of high-voltage electrical injury, resulting from direct electrical and thermal damage to ocular tissues. Although cataract formation is the most commonly reported manifestation, electrical injury should be regarded as a pan-ocular insult capable of affecting both anterior and posterior segment structures. Delayed posterior segment complications, particularly rhegmatogenous retinal detachment (RRD), remain poorly characterized and may be overlooked during early management. Case presentation: We report the case of a patient who developed unilateral electric cataract following a high-voltage electrical injury. During primary surgery, posterior capsule rupture with complete posterior dislocation of the lens nucleus was observed, and pars plana vitrectomy (PPV) with lensectomy was performed. Despite initially favorable postoperative recovery, the patient presented 86 days later with macula-involving RRD characterized by multiple retinal breaks and star-shaped retinal folds. A secondary PPV combined with epiretinal membrane peeling, endolaser photocoagulation, and silicone oil tamponade was undertaken, resulting in successful retinal reattachment. After silicone oil removal, best-corrected visual acuity improved and stabilized at 0.5, with the retina remaining flat during follow-up. Conclusion: This case highlights that electrical ocular injury represents a dynamic and progressive process rather than a static event confined to the time of trauma. Successful management of anterior segment pathology does not preclude the development of delayed, sight-threatening posterior segment complications. Long-term, vigilant vitreoretinal surveillance is essential in patients with electrical eye injuries to enable early detection and timely intervention, thereby preventing irreversible vision loss.