Nonarteritic anterior ischemic optic neuropathy after uneventful phacoemulsification: case report

Fontes, Bruno Machado; Jung, Liang Shih; Soriano, Eduardo; Chicani, Carlos Filipe

doi:10.1590/s0004-27492007000300029

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…Detailed characteristics of cases and controls are summarized in Table 2. A further 19 case series and reports with individual information on operative factors were summarized in the Supplemental Digital Content (See Supplementary Data, http://links.lww.com/WNO/A604) (9,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37).…”

Section: Included Study and Participant Characteristicsmentioning

confidence: 99%

Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery: A Systematic Review and Meta-Analysis

Shew¹,

Wang²,

Danesh‐Meyer³

2022

Journal of Neuro-Ophthalmology

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Background: Nonarteritic anterior ischemic optic neuropathy (NAION) has been reported to occur after cataract surgery. It is not clearly established whether cataract surgery increases the risk of NAION over baseline. Evidence Acquisition: Medline, PubMed, Embase, and Cochrane Central registers were systematically searched for eligible studies reporting on postcataract surgery NAION (psNAION) within 1 year. All peer-reviewed publications with events n $ 10 were included. Pooled incidence and odds/hazard ratios and 95% confidence intervals (CIs) were extracted and calculated using random effect models for early and delayed psNAION. Time to event data were pooled for temporal analysis of psNAION events within the first year. This systematic review was registered (PROS-PERO CRD42021274383). Results: Nine articles met the selection criteria with five studies suitable for meta-analysis. A total of 320 psNAION cases, 1,307 spontaneous NAION (sNAION) cases, 1,587,691 cataract surgeries, and 1,538,897 noncataract surgery controls were included. Pooling of 63,823 cataract surgeries and 161,643 controls showed a hazard ratio of 4.6 (95% CI 2.7-7.8) of psNAION within 1 year of surgery. Pooled unadjusted incidence of psNAION within 2 months was ) per 100,000/year, psNAION within 1 year was 32.36 (95% CI 9.38-55.34) per 100,000/year, and sNAION was 8.87 (95% CI 2.12-15.62) per 100,000/ year. psNAION cases were older by a mean of 7.6 years; otherwise, pooled odds ratios for baseline risk factors in psNAION vs. sNAION cases were not statistically significant. psNAION within the first year peaked within 72 hrs and at 6 weeks after the surgery with 73% of cases occurring within 6 months. Conclusion:The risk of NAION after cataract surgery is four times greater within the first year and usually occurs within 6 months. However, the absolute risk remains low at 1 in 1,000-3,100 surgeries and is unlikely to warrant extra mention for consenting.

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Section: Included Study and Participant Characteristicsmentioning

confidence: 99%

Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery: A Systematic Review and Meta-Analysis

Shew¹,

Wang²,

Danesh‐Meyer³

2022

Journal of Neuro-Ophthalmology

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“…So we wonder whether the fluctuation of intraocular perfusion pressure during phacoemulsification affect fundus microcirculation and then affect the patient's postoperative vision. A few studies have reported the effects of cataract surgery on ocular hemodynamics[10][11][12]. However, there is a shortage of research on this issue and there is a lack of quantitative study and large number of cases.…”

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confidence: 99%

Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal eyes

2021

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Background: To quantitatively evaluate the possible effects of phacoemulsification cataract surgery on macular hemodynamics using optical coherence tomography angiography (OCTA). Methods Prospective observational study. Superficial and deep macular vascular densities as well as parameters of foveal avascular zone (FAZ) were measured preoperatively (baseline) and at 1 day, 1week and 4 weeks postoperation in normal eyes (≥22 mm and≤24 mm) of patients scheduled for phacoemulsification cataract surgery with intraocular lens implantation. Correlations between the rate of change of pre-and post-operative vascular densities and surgical parameters were analyzed.Results : 123 eyes of 107 patients were recruited. Compared with baseline measurements, no statistically significant variation was found in macular vascular densities of day one after surgery (P>0.05). While both superficial and deep macular vascular densities were significantly increased postoperatively on week 1 and week 4 (P<0.05; P<0.05). There were no statistically significant differences in any of the FAZ parameters between the baseline measurements and the entire followup period (P>0.05 for all). There were no statistically significant correlations between main surgical parameters and the macular vascular densities. Conclusions : In normal eyes, macular blood perfusion gradually increased after phacoemulsification cataract surgery and was stabilized in one week. Foveal avascular zone was basically stable before and after surgery. Main parameters and intraoperative perfusion of phacoemulsification surgery may not be the key factors affecting macular hemodynamics.

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“…10 Ortaya çıkış zamanına göre ameliyattan birkaç saat veya gün sonra olabileceği gibi, aylar sonra da olabilmektedir. 6,[11][12][13] Erken dönemde ortaya çıkan NAAİON etiyolojisinde göz içi basınç artışı, lokal anesteziye bağlı intraorbital basınç artışı, hipotoni veya sistemik hipotansiyon ileri sürülmekte, geç dönemde ortaya çıkan NAAİON için ise yeterli açıklama yapılamamaktadır. 6,11 Geç dönemdeki olgularda ileri sürülen görüş intraoküler inflamasyona bağlı vaskülopati varlığıdır.…”

Section: Discussionunclassified

“…5,[17][18][19][20][21][22] Tromboembolik bir hastalıktan çok hipotansif bir hastalık olduğu düşünülen NAAİON'nin tedavisinde Aspirin kullanımının etkili olmadığı, ancak ikinci göz tutulumu olasılığına karşı kullanılabileceği bildirilmektedir. 12,22 Nonarteritik anterior iskemik optik nöropati gelişimine karşı olası risk faktörlerinin kontrolü en iyi korunma yöntemidir. Özellikle bir gözünde NAAİON gelişmiş kişilerde diğer gözün NAAİON geçirme olasılığının arttığı ve ilk 5 yıldaki risk oranının %30-53 arasında olduğu saptanmıştır.…”

Section: Discussionunclassified

Cataract Surgery and Non-arteritic Anterior Ischemic Optic Neuropathy

Sefi-Yurdakul¹,

Koç²

2016

Turkiye Klinikleri J Ophthalmol

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Nonarteritic anterior ischemic optic neuropathy after uneventful phacoemulsification: case report

Cited by 10 publications

References 19 publications

Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery: A Systematic Review and Meta-Analysis

Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery: A Systematic Review and Meta-Analysis

Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal eyes

Cataract Surgery and Non-arteritic Anterior Ischemic Optic Neuropathy

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