Yoshimoto Miwako, Matsumoto Shun
Department of Ophthalmology, Tokyo Teishin Hospital, Tokyo, Japan.
J Cataract Refract Surg. 2004 Mar;30(3):722-5. doi: 10.1016/j.jcrs.2003.07.014.
We report a case of orbital varix rupture during cataract surgery with retrobulbar anesthesia. No remarkable changes were observed 10 minutes after retrobulbar anesthesia was administered, but a rise in intraocular and intraorbital pressure was noted about 10 minutes after phacoemulsification began. The eyelid could not be closed at the end of surgery because of severe proptosis. Follow-up by magnetic resonance imaging and color Doppler imaging revealed orbital hemorrhage and varix. Based on the time of its appearance, the hemorrhage was thought to be the result of venous congestion caused by anesthetic agent in the muscle cone. Although intermittent exophthalmos is a symptom of orbital varix, silent orbital varix should be considered when selecting the method of anesthesia for ocular surgery.
我们报告一例在球后麻醉下白内障手术期间眼眶静脉曲张破裂的病例。球后麻醉给药10分钟后未观察到明显变化，但在超声乳化开始约10分钟后，眼内压和眶内压升高。由于严重眼球突出，手术结束时眼睑无法闭合。磁共振成像和彩色多普勒成像随访显示眼眶出血和静脉曲张。根据出血出现的时间，推测出血是肌锥内麻醉剂导致静脉充血的结果。虽然间歇性眼球突出是眼眶静脉曲张的症状，但在选择眼科手术麻醉方法时应考虑隐匿性眼眶静脉曲张。
