Iatrogenic Central Retinal Artery Occlusion Following Retrobulbar Anesthesia for Intraocular Surgery.
10.3341/kjo.2015.29.4.233
- Author:
Eun Hye JUNG
1
;
Kyu Hyung PARK
;
Se Joon WOO
Author Information
1. Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Observational Study ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Cataract;
Intraocular surgery;
Retinal artery occlusion;
Retrobulbar anesthesia;
Vitrectomy
- MeSH:
Aged;
Anesthesia/*adverse effects/methods;
Anesthetics, Local/administration & dosage/*adverse effects;
Female;
Fluorescein Angiography;
Follow-Up Studies;
Fundus Oculi;
Humans;
*Iatrogenic Disease;
Male;
Middle Aged;
Ophthalmologic Surgical Procedures/*adverse effects;
Orbit;
*Postoperative Complications;
Retinal Artery Occlusion/diagnosis/*etiology;
Retrospective Studies;
Visual Acuity
- From:Korean Journal of Ophthalmology
2015;29(4):233-240
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To present clinical features of central retinal artery occlusion (CRAO) following retrobulbar anesthesia for intraocular surgery. METHODS: This observational case series describes 5 consecutive patients with acute CRAO following retrobulbar anesthesia for intraocular surgery. Data collected for this study included subject characteristics, retrobulbar anesthesia technique, treatment type, initial and final best-corrected visual acuity, and other ophthalmologic examinations. RESULTS: Mean subject age was 67.0 +/- 8.2 years (range, 53 to 72 years). All patients had one or more vascular risk factors (e.g., hypertension, cerebral infarction, carotid artery stenosis) and presented with acute vision loss 1 day after uneventful intraocular surgery (cataract surgery in 2 eyes and vitrectomy in 3 eyes). All 5 patients received retrobulbar anesthesia during surgery, 4 of which involved the use of a sharp needle. No immediate complications were noted during intraocular surgery. Final visual prognosis was poor (from finger count to no light perception) although intraocular thrombolysis was attempted in 3 patients. CONCLUSIONS: Iatrogenic CRAO is a potential complication of retrobulbar anesthesia for intraocular surgery in elderly patients with vascular risk factors. Unfortunately, this complication can lead to severe vision loss. We conclude that retrobulbar anesthesia for intraocular surgery should be performed with great care and special consideration for elderly patients with vascular risk factors.
