Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Ophthalmologica. 2010;224(2):103-8. doi: 10.1159/000235858. Epub 2009 Sep 1.
To investigate the visual sensations experienced by patients during vitrectomy under retrobulbar anesthesia.
30 men and 45 women with a mean age of 65.3 +/- 10.6 years underwent vitrectomy under retrobulbar anesthesia for macular disease. 28 eyes had an idiopathic epiretinal membrane, 13 had an idiopathic macular hole, 32 had macular edema (17 diabetic retinopathy and 15 retinal vein occlusion), and 2 had submacular hemorrhage. 49 patients with nonmacular disease underwent similar vitrectomy procedures and were used for comparison. An interview was conducted with the patient about his/her visual sensations during and within 3 h of the vitrectomy.
70 (93.3%) of the patients reported seeing lights, 53 (70.7%) reported seeing colors, and 48 (64.0%) reported seeing movements or moving objects. Of the patients who reported seeing movements or moving objects, 44 (58.7%) reported seeing surgical instruments, and 5 (6.7%) saw the surgeon's fingers or hands. Patients with macular diseases tended to report more visual sensations than patients with nonmacular diseases. The patients' description and drawings appeared to arise mainly from the shadows cast by the intravitreal objects, and some patients perceived highly accurate details including the movements and color of the objects.
Visual sensations are experienced by approximately 90% of the patients, and there may be a common mechanism by which patients perceive the intravitreal objects that are not focused on by the retina through the eye's optical system.
调查球后麻醉下玻璃体切除术患者的视觉感受。
30 名男性和 45 名女性，平均年龄 65.3±10.6 岁，因黄斑疾病接受球后麻醉下玻璃体切除术。28 只眼为特发性视网膜内膜，13 只眼为特发性黄斑裂孔，32 只眼为黄斑水肿（17 只糖尿病性视网膜病变，15 只视网膜静脉阻塞），2 只眼为黄斑下出血。49 名患有非黄斑疾病的患者接受了类似的玻璃体切除术，并用于比较。对患者进行了玻璃体切除术期间和术后 3 小时内的视觉感受访谈。
70（93.3%）名患者报告看到了光，53（70.7%）名患者报告看到了颜色，48（64.0%）名患者报告看到了运动或移动的物体。在报告看到运动或移动的物体的患者中，44（58.7%）名患者报告看到了手术器械，5（6.7%）名患者看到了外科医生的手指或手。患有黄斑疾病的患者比患有非黄斑疾病的患者更倾向于报告视觉感受。患者的描述和绘画似乎主要来自于眼内物体的阴影，一些患者感知到了高度准确的细节，包括物体的运动和颜色。
大约 90%的患者会经历视觉感受，并且可能存在一种通过眼睛的光学系统感知视网膜未聚焦的眼内物体的共同机制。
