白内障手术中前房内注射麻醉剂后出现短暂性完全视力丧失。
Transient complete visual loss after intracameral anesthetic injection in cataract surgery.
作者信息
Eshraghi Bahram, Katoozpour Ramon, Anvari Pasha
机构信息
Farabi Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
J Curr Ophthalmol. 2016 Feb 5;27(3-4):129-31. doi: 10.1016/j.joco.2015.12.005. eCollection 2015 Sep-Dec.
PURPOSE
We describe a case of transient visual loss following cataract surgery with unpreserved intracameral lidocaine.
METHOD
A 50-year-old man with posterior polar cataract underwent phacoemulsification. Following capsulorhexis and hydrodelineation with 0.5 cc of unpreserved lidocaine 1%, a portion of fluid reached behind the crystalline lens and caused the posterior capsule rupture. Cataract extraction and anterior vitrectomy were performed. Anesthetic administration was repeated to relieve the discomfort felt by the patient. A three-piece hydrophobic acrylic intraocular lens was implanted in the ciliary sulcus.
RESULTS
On the first postoperative morning, the patient's vision was recorded as having no light perception. The relative afferent pupillary defect (RAPD) was found to be 4+. The retina and optic nerve head appeared normal. In the afternoon, the visual acuity (VA) was improved to 3-m count-finger. On the second postoperative morning, the patient's VA was improved to 4/10. On the third postoperative day, his VA returned to normal at 20/20 without RAPD.
CONCLUSION
In the event of posterior capsular rupture, to reduce retinal toxicity risks, intracameral lidocaine should not be repeated.
目的
我们描述了一例白内障手术后因使用未保存的前房内利多卡因导致短暂视力丧失的病例。
方法
一名患有后极性白内障的50岁男性接受了超声乳化白内障吸除术。在进行连续环形撕囊并使用0.5毫升未保存的1%利多卡因进行水分离后，一部分液体到达晶状体后方并导致后囊破裂。进行了白内障摘除和前部玻璃体切除术。重复给予麻醉剂以缓解患者的不适。在睫状沟植入了一片式疏水丙烯酸人工晶状体。
结果
术后第一天早晨，记录患者视力为无光感。发现相对传入性瞳孔障碍（RAPD）为4+。视网膜和视神经乳头外观正常。下午，视力（VA）提高到能数3米处手指。术后第二天早晨，患者的视力提高到4/10。术后第三天，他的视力恢复正常，为20/20，且无RAPD。
结论
如果发生后囊破裂，为降低视网膜毒性风险，不应重复使用前房内利多卡因。
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