Levin M L, O'Connor P S
University of Texas Health Science Center, San Antonio.
Ann Ophthalmol. 1989 Sep;21(9):337-9.
Patients often say that they can see the surgical instruments with the operated eye during intraocular surgery. We examined 26 consecutive patients for visual acuity, ocular motility, and pupillary response before, during, and after retrobulbar anesthesia for cataract extraction. Twenty minutes after the anesthetic was injected, 19% of these patients had visual acuities better than 6/200, and 73% of patients described the movements of the instruments during surgery. Two patients (8%) recognized details on the ceiling after insertion of the intraocular lens. An afferent pupillary defect was found in 31% of patients. Although retrobulbar anesthesia results in a marked decrease in ocular motility and visual acuity, total akinesia and blindness do not occur. An incidental result of retrobulbar anesthesia may be a transient afferent pupillary defect.
患者常称在眼内手术过程中能用手术眼看到手术器械。我们对26例连续行球后麻醉以行白内障摘除术的患者在麻醉前、麻醉期间及麻醉后检查了视力、眼球运动和瞳孔反应。注射麻醉剂20分钟后，这些患者中有19%的视力优于6/200，73%的患者描述了手术期间器械的移动。2例患者（8%）在植入人工晶状体后认出了天花板上的细节。31%的患者发现有传入性瞳孔缺陷。尽管球后麻醉会导致眼球运动和视力显著下降，但不会出现完全性运动不能和失明。球后麻醉的一个意外结果可能是短暂的传入性瞳孔缺陷。
