Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland.
J Arthroplasty. 2011 Feb;26(2):338.e17-9. doi: 10.1016/j.arth.2009.11.010. Epub 2010 Feb 9.
Perioperative visual loss (PVL) is a very rare and unpredictable complication of surgery performed at distance from the visual pathways, mostly after spine or cardiac procedures. We report 6 consecutive patients with PVL after routine orthopedic procedures (osteosynthesis for complex fracture of the femur [2], total hip arthroplasty [2], hip prosthesis arthroplasty [1], bilateral simultaneous total knee arthroplasty [1]) and reviewed the literature on the subject. An ischemic optic neuropathy was diagnosed in all cases, and visual loss was bilateral in 5 of 6 patients. Partial visual improvement occurred in only 3 of 11 eyes. No specific therapy is available for PVL. Postoperative visual disturbances should prompt without delay an ophthalmic evaluation because emergent correction of anemia, systemic hypotension, or hypovolemia might improve visual prognosis of PVL.
围手术期视力丧失（PVL）是一种非常罕见且难以预测的手术并发症，通常发生在远离视觉通路的部位，主要发生在脊柱或心脏手术后。我们报告了 6 例连续患者在常规骨科手术后发生 PVL（股骨复杂骨折的骨愈合[2]、全髋关节置换术[2]、髋关节假体置换术[1]、双侧同时全膝关节置换术[1]），并回顾了该主题的文献。所有病例均诊断为缺血性视神经病变，6 例中有 5 例视力丧失为双侧。仅 11 只眼中的 3 只出现部分视力改善。对于 PVL，目前尚无特定的治疗方法。术后视力障碍应立即进行眼科评估，因为及时纠正贫血、全身性低血压或低血容量可能会改善 PVL 的视力预后。
