To report a case of ulnar neuropathy as an extraocular complication following retinal detachment surgery and face-down positioning.

A 65-year-old woman was referred to our hospital with decreased visual acuity in the left eye. Fundus examination revealed a rhegmatogenous retinal detachment not involving the macula in the left eye. A vitrectomy with scleral encircling and 18% SF6 gas tamponade was performed. The patient was instructed to assume a face-down position. After 5 days, the patient reported having paresthesia and numbness of the left 4th and 5th fingers. Neurologic exams were performed and the results indicated ulnar neuropathy. There was no improvement in the neurologic symptoms during the 6-month follow-up.

Surgeons performing retinal surgery should caution their patients of ulnar neuropathy when face-down positioning is required. The patients should be instructed to minimize the time spent with their elbows flexed in a stationary position. Additionally, the pressure loaded on the bent elbow should be minimized.