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经皮肾镜取石术后单侧术后视力丧失:一例病例报告。

Unilateral postoperative visual loss after percutaneous nephrolithotomy: a case report.

作者信息

Xu Guolin, Wang Yuqing, Zhang Qing, Yao Wenjun, Wu Xiaosan, Li Rui

机构信息

Department of Anesthesiology and Perioperative Medicine, Second Affiliated Hospital of Anhui Medical University, No 678 Furong Road, 230601, Hefei, China.

Department of Ophthalmology, Second Affiliated Hospital of Anhui Medical University, No 678 Furong Road, Hefei, 230601, China.

出版信息

BMC Anesthesiol. 2025 Jul 1;25(1):310. doi: 10.1186/s12871-025-03190-z.

Abstract

Postoperative visual loss (POVL) after non-ocular surgeries is rare, and its occurrence following percutaneous nephrolithotomy (PCNL) is exceedingly uncommon. A 60-year-old male with hypertension and type 2 diabetes mellitus underwent PCNL in the prone position for a right renal calculus. Shortly after surgery, he reported unilateral visual loss. Ophthalmologic assessment revealed profound vision impairment in the right eye. Imaging confirmed occlusion of the right ophthalmic artery. A multidisciplinary team including ophthalmology, neurology, and interventional radiology coordinated prompt intervention. Emergency intra-arterial thrombolysis restored blood flow and led to gradual recovery of visual function. This case illustrates a rare but serious complication of POVL due to ophthalmic artery occlusion after PCNL. Prompt recognition and timely multidisciplinary intervention were key to successful visual recovery. Clinicians should remain vigilant for POVL in high-risk patients undergoing prone-position surgeries.

摘要

非眼科手术后的术后视力丧失(POVL)很少见,经皮肾镜取石术(PCNL)后发生这种情况极为罕见。一名患有高血压和2型糖尿病的60岁男性因右肾结石在俯卧位接受了PCNL。术后不久,他报告单侧视力丧失。眼科评估显示右眼有严重视力障碍。影像学检查证实右眼动脉闭塞。包括眼科、神经科和介入放射科在内的多学科团队协调进行了及时干预。紧急动脉内溶栓恢复了血流,并导致视力功能逐渐恢复。该病例说明了PCNL后因眼动脉闭塞导致的罕见但严重的POVL并发症。及时识别和及时的多学科干预是视力成功恢复的关键。临床医生应对接受俯卧位手术的高危患者的POVL保持警惕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2aa/12211418/4f7e345d0394/12871_2025_3190_Fig1_HTML.jpg

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