Lee Hun, Kim Chan Yun, Seong Gong Je, Ma Kyoung Tak
Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2010 Feb;24(1):57-61. doi: 10.3341/kjo.2010.24.1.57. Epub 2010 Feb 5.
The purpose of this article is to report a case of nonarteritic anterior ischemic optic neuropathy (NAION) after uneventful cataract surgery. A 53-year-old Filipina underwent cataract surgery. She had a small optic disc with cup-to-disc ratio of 0.2 in the left eye and 0.3 in the right eye. On the first postoperative day, the uncorrected visual acuity (UCVA) was 20/20, with an intraocular pressure (IOP) of 20 mmHg in the left eye. At one week after operation, the UCVA was 20/20 and the IOP was 15 mmHg. Three weeks later, she underwent cataract surgery in the right eye. On the first postoperative day, her UCVA was 20/20 in both eyes, but she complained of a visual field decrease in the left eye. A relative afferent pupillary defect (RAPD) was noted and the optic disc was pallid and swollen diffusely. A red-free photo showed defect surrounding the optic disc. A visual field test showed tunnel vision sparing the central vision. In this report, the authors hypothesize an association between cataract extraction and delayed NAION. Since the risk of NAION in the fellow eye is 30-50%, visual acuity, visual field, fundus exam and RAPD should be routinely checked.
本文旨在报告一例白内障手术顺利完成后发生非动脉炎性前部缺血性视神经病变（NAION）的病例。一名53岁的菲律宾女性接受了白内障手术。她的视盘较小，左眼杯盘比为0.2，右眼为0.3。术后第一天，左眼未矫正视力（UCVA）为20/20，眼压（IOP）为20mmHg。术后一周，UCVA为20/20，IOP为15mmHg。三周后，她右眼接受了白内障手术。术后第一天，她双眼UCVA均为20/20，但她主诉左眼视野缩小。检查发现有相对传入性瞳孔障碍（RAPD），视盘苍白且弥漫性肿胀。无赤光照片显示视盘周围有缺损。视野检查显示为保留中心视力的管状视野。在本报告中，作者推测白内障摘除与迟发性NAION之间存在关联。由于对侧眼发生NAION的风险为30%-50%，因此应常规检查视力、视野、眼底及RAPD。
