Perioperative Visual Changes

Warner, Matt; Fronapfel, Paul J.; Hebl, James R.; Herman, David C.; Warner, David O.; Decker, Paul; Warner, Mark A.

doi:10.1097/00000542-200204000-00012

Cited by 22 publications

(17 citation statements)

References 4 publications

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“…Vier Patienten (0,0008%) erlitten bleibenden nichtoperationsbedingten POVL [30]. Eine der wenigen prospektiven Studien zur POVL-Problematik wurde an 671 nichtophthalmologischen chirurgischen Patienten durchgeführt [29]. Dabei wurde bei 46 Patienten (6,9%) postoperativ eine neu aufgetretene Visusminderung festgestellt.…”

Section: Inzidenzunclassified

Erblindung nach nichtophthalmologischen Eingriffen

Shmygalev

Heller

2011

Anaesthesist

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Perioperative visual loss (POVL) after nonocular surgery is a rare but unexpected event and represents a devastating complication. It is most often associated with cardiac, spinal as well as head and neck surgery. The etiology of POVL remains incompletely understood. Any portion of the visual system may be involved, from the cornea to the occipital lobe. The most common site of permanent injury is, however, the optic nerve itself and ischemia is the most often presumed mechanism. Multiple factors have been proposed as risk factors for POVL, including long duration in the prone position, decreased ocular perfusion pressure, excessive blood loss and anemia, hypotension, hypoxia, excessive fluid replacement, elevated venous pressure, head positioning and a patient-specific vascular susceptibility which may be anatomic or physiologic. However, the risk factors for any given patient or procedure may vary. The underlying specific pathogenesis of these neuro-ophthalmic complications remains unknown and physicians should be alert to the potential for loss of vision in the postoperative period. This review updates readers on the incidence, suspected risk factors, diagnosis and treatment of POVL in the setting of nonocular surgery.

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Section: Inzidenzunclassified

Erblindung nach nichtophthalmologischen Eingriffen

Shmygalev

Heller

2011

Anaesthesist

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“…Fifty-five of these patients developed bilateral blurred vision, and eight cases complained of unilateral blurred vision on the side ipsilateral to the operation. Visual change is not uncommon after nonocular surgery, and the change can range from transient blurred vision to irreversible blindness [14]. The most commonly reported cause is corneal abrasion, which could be caused by direct trauma to the cornea from the face mask, surgical drapes, or other foreign objects contacting the eyes accidentally during anesthesia [14,15].…”

Section: Blurred Visionmentioning

confidence: 99%

Rarely reported ocular complications following surgery to correct chronic suppurative otitis media

Zhao

Lü

et al. 2011

Eur Arch Otorhinolaryngol

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The objective of this study was to describe the rarely reported ocular complications following surgery to correct chronic suppurative otitis media. A retrospective analysis was made of 2,318 cases of chronic suppurative otitis media treated with surgery between January 2004 and December 2009 at West China Hospital, Sichuan University, a medical center in Western China. Ninety-two cases of ocular complications were identified, giving an incidence of 3.97%. In 63 of the 92 cases (68.48%), the patients complained of blurred vision and the condition was classified as grade 1. In 24 cases (26.09%), the patients complained of mild periorbital edema and the condition was classified as grade 2. Four cases (4.35%) were classified as grade 3 because of severe edema with erythema on eyelids. One case (1.09%) was classified as grade 4 because of periorbital ecchymosis in addition to edema. The clinical features and the possible etiology were analyzed and are discussed. Ocular complications following chronic suppurative otitis media surgery are rare. Preauricular incision, disturbance of venous and lymphatic drainage, and preseptal cellulitis were the possible etiological factors. Eye injury during surgery and use of an anticholinergic agent might be risk factors for blurred vision after this surgery.

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“…Dabei variieren die Angaben zur Inzidenz perioperativer ophthalmologischer Komplikationen stark, näm-lich von 0-100, abhängig von der untersuchten Population, der Studienmethodik und den beobachteten Endpunkten [4]. Bemerkenswert ist jedoch, dass in der bislang einzigen prospektiven Untersuchung zu perioperativen Verände-rungen des Sehvermögens nach allgemeinchirurgischen Eingriffen von Warner et al [50] bei immerhin 4,2 der Patienten (28 von 671) post operativ ein neu aufgetretenes "verschwommenes Se hen", das über mindestens 3 Tage anhielt, beobachtet wurde; bei 7 Patienten (1 dieser Population) war eine Refraktionskorrektur notwendig (. Tab.…”

Section: Inzidenz Postoperativer Sehstörungen Und Erblindungunclassified

“…Die Inzidenz einer postoperativen Erblindung ist im Gesamtkollektiv chirurgischer Patienten sehr gering und wird mit 0,0016 (1:61.000), [38] und 0,0008 (1:125.234) [50] angegeben (. Tab.…”

Section: Inzidenz Postoperativer Sehstörungen Und Erblindungunclassified

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