Visual Impairment after Laparoscopic Donor Nephrectomy

Metwalli, Adam R.; Davis, Ryan G.; Donovan, James F.

doi:10.1089/end.2004.18.888

Cited by 13 publications

(4 citation statements)

References 21 publications

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“…Any potential interruption to optic blood flow autoregulation may lead to postoperative visual loss [2]. Partial or total blindness after non-ophthalmic surgery has been reported in patients who experience an increase in IOP beyond the normal range [5,6,7]. Although our patient was in a relapsed phase of Posner-Schlossman syndrome and his IOP was within the normal range at the time of surgery, attention is warranted during surgery because some of these patients have atypical presentation, with elevated IOP between attacks [1,4].…”

Section: Discussionmentioning

confidence: 99%

Point-of-care monitoring of perioperative intraocular pressure using portable tonometry in a patient with Posner-Schlossman syndrome: a case report

Kim

Rhim

Moon

et al. 2014

Korean J Anesthesiol

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A 56-year-old man with a rotator cuff injury, scheduled for arthroscopic reconstruction surgery, had a history of recurrent symptoms of eyeball pain and blurred vision for several years. After close examination, he was diagnosed with Posner-Schlossman syndrome. Three weeks before the scheduled surgery, his intraocular pressure (IOP) increased (> 30 mmHg) and he became extremely anxious about the surgery. We monitored his IOP intraoperatively and successfully completed general anesthesia without any sequelae. As Posner-Schlossman syndrome can present with severe complications that may lead to postoperative visual loss, intraoperative monitoring of intraocular monitoring and careful anesthetic management are crucial to protect vision.

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Section: Discussionmentioning

confidence: 99%

Point-of-care monitoring of perioperative intraocular pressure using portable tonometry in a patient with Posner-Schlossman syndrome: a case report

Kim

Rhim

Moon

et al. 2014

Korean J Anesthesiol

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“…8 Further cases have been reported after laparoscopic procedures of prostatectomy, nephrectomy, herniotomy, and colorectal resection. [9][10][11][12] 4 Corneal abrasions Several surgical procedures including laparoscopy Gild WM et al 6 Corneal abrasions Several surgical procedures including laparoscopy Shen Y et al 7 POVL Colecystectomy, spinal surgery, appendectomy, colorectal resection Lee LA et al 8 POVL Spine surgery Weber ED et al 9 POVL Prostatectomy Metwalli AR et al 11 POVL Nephrectomy Mizrahi et al 12 POVL Proctocolectomy Myers MA et al 13 POVL Spine surgery Hoff J et al 16 POVL Spine surgery The Postoperative Visual Loss Study Group 17 POVL Spine surgery Kumar G et al 21 POVL Colorectal surgery Awad H et al 22 IOP elevation Robot-assisted radical prostatectomy Sugata A et al 31 IOP elevation Spine surgery Farag E et al 39 IOP elevation Spine surgery Mowafi HA et al 40 IOP elevation Gynecologic laparoscopy Hwang JW et al 41 IOP elevation Pelvic laparoscopy, colecistectomy Stambough JL et al 42 POVL Spine surgery Holy SE et al 52 POVL Spine surgery POVL = Perioperative Vision Loss; IOP = Intraocular pressure It has been documented that the onset of POVL may occur immediately after patient awakening from anesthesia, or alternatively between the first and the twelfth day after surgery (with the majority of cases reported at 48 hours after the procedure). 13 The most frequent condition (89% after spinal surgery 14 ) is represented by ischemic optic neuropathy (ION), caused by reduced ocular blood flow, 15 while less frequent causes of POVL are central retinal artery occlusion (11%, caused primarily by external compression of the eyeball 13 ) and cortical infarction.…”

Section: Findings Epidemiology and Characteristics Of Ocular Complimentioning

confidence: 99%

Ocular Complications in Laparoscopic Surgery: Review of Existing Literature and Possible Prevention and Treatment

Nuzzi

Tridico

2015

Seminars in Ophthalmology

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During laparoscopic surgery, ocular complications are possible, sometimes leading to devastating visual losses, hardly susceptible to recovery, although rare. Principal ocular adverse events are represented by corneal abrasions and the perioperative visual loss (POVL). POVL onset is related to intraocular pressure elevations (particularly after patient positioning in Trendelenburg or prone decubitus, depending on the surgical procedure), anesthesiologic factors and patients' characteristics. In the light of evidence from the existing literature, the authors suggest surgical and anesthesiologic measures to prevent and manage ocular complications in laparoscopic surgery. Apart from general recommendations, this article indicates practical guidelines specific for robot-assisted laparoscopic interventions and spinal surgery, as well as laparoscopic colorectal resection, radical prostatectomy, and gynecologic surgery. In conclusion, in order to better manage these complications, it is advisable to develop an interdisciplinary collaboration between surgeons, anesthesiologists, and ophthalmologists, on a procedural and medico-legal level, with the intent of mutual training.

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“…8 However, there have been cases of ION development in patients with blood pressure readings .90 mmHg 24 and in those with minimal (less than 500 mL) blood loss. 10,25,26 Postoperative AION occurs most often after cardiac surgery, especially CABG. The mild to moderate hypothermia used during bypass could cause increased blood viscosity, which may lead to watershed infarction of the optic nerve.…”

Section: Pathogenesis Risk Factors and Outcomesmentioning

confidence: 99%

Perioperative visual loss in ocular and nonocular surgery

Berg

Harrison

Lee

2010

OPTH

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Incidence estimates for perioperative vision loss (POVL) after nonocular surgery range from 0.013% for all surgeries up to 0.2% following spine surgery. The most common neuro-ophthalmologic causes of POVL are the ischemic optic neuropathies (ION), either anterior (AION) or posterior (PION). We identified 111 case reports of AION following nonocular surgery in the literature, with most occurring after cardiac surgery, and 165 case reports of PION following nonocular surgery, with most occurring after spine surgery or radical neck dissection. There were an additional 526 cases of ION that did not specify if the diagnosis was AION or PION. We also identified 933 case reports of central retinal artery occlusion (CRAO), 33 cases of pituitary apoplexy, and 245 cases of cortical blindness following nonocular surgery. The incidence of POVL following ocular surgery appears to be much lower than that seen following nonocular surgery. We identified five cases in the literature of direct optic nerve trauma, 47 cases of AION, and five cases of PION following ocular surgery. The specific pathogenesis and risk factors underlying these neuro-ophthalmic complications remain unknown, and physicians should be alert to the potential for loss of vision in the postoperative period. Method of literature reviewWe searched the National Library of Medicine's PubMed database with a subsequent review of the accompanying references (last accessed February 8, 2010). The major search words and word combinations included: posterior ischemic optic neuropathy; anterior ischemic optic neuropathy; central retinal artery occlusion; pituitary apoplexy; cortical blindness; optic nerve trauma; postoperative vision loss; postoperative blindness; perioperative vision loss; perioperative blindness; and ocular surgery. In addition, the citations from the above searches were also included. Cases from the non-English literature and cases prior to 1970 were not included. Cases with documented direct surgical trauma to orbital structures other than the optic nerve were not included.

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Visual Impairment after Laparoscopic Donor Nephrectomy

Cited by 13 publications

References 21 publications

Point-of-care monitoring of perioperative intraocular pressure using portable tonometry in a patient with Posner-Schlossman syndrome: a case report

Point-of-care monitoring of perioperative intraocular pressure using portable tonometry in a patient with Posner-Schlossman syndrome: a case report

Ocular Complications in Laparoscopic Surgery: Review of Existing Literature and Possible Prevention and Treatment

Perioperative visual loss in ocular and nonocular surgery

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