Oncel Murat, Sunam Guven Sadi, Varoglu Asuman Orhan, Karabagli Hakan, Yildiran Huseyin
Department of Thoracic Surgery, Selcuk University Medical School, Konya, Turkey.
Department of Neurology, Selcuk University Medical School, Konya, Turkey.
Surg J (N Y). 2016 Feb 4;2(1):e14-e16. doi: 10.1055/s-0036-1571440. eCollection 2016 Mar.
Transient vision loss after major surgical procedures is a rare clinical complication. The most common etiologies are cardiac, spinal, head, and neck surgeries. There has been no report on vision loss after lung resection. A 65-year-old man was admitted to our clinic with lung cancer. Resection was performed using right upper lobectomy with no complications. Cortical blindness developed 12 hours later in the postoperative period. Results from magnetic resonance imaging and diffusion-weighted investigations were normal. The neurologic examination was normal. The blood glucose level was 92 mg/dL and blood gas analysis showed a PO of 82 mm Hg. After 24 hours, the patient began to see and could count fingers, and his vision was fully restored within 72 hours after this point. Autonomic dysfunction due to impaired microvascular structures in diabetes mellitus may induce posterior circulation dysfunction, even when the hemodynamic state is normal in the perioperative period. The physician must keep in mind that vision loss may occur after lung resection due to autonomic dysfunction, especially in older patients with diabetes mellitus.
大手术术后短暂性视力丧失是一种罕见的临床并发症。最常见的病因是心脏、脊柱、头部和颈部手术。目前尚无肺切除术后视力丧失的报道。一名65岁男性因肺癌入住我院。行右上叶切除术，无并发症。术后12小时出现皮质盲。磁共振成像和弥散加权检查结果正常。神经系统检查正常。血糖水平为92mg/dL，血气分析显示氧分压为82mmHg。24小时后，患者开始能看见并能数手指，此后72小时内视力完全恢复。糖尿病患者微血管结构受损导致的自主神经功能障碍可能诱发后循环功能障碍，即使围手术期血流动力学状态正常。医生必须牢记，肺切除术后可能因自主神经功能障碍导致视力丧失，尤其是老年糖尿病患者。
