Vision Loss following Small Incision Cataract Surgery: A Case Report
DOI:
https://doi.org/10.22502/jlmc.v9i1.390Keywords:
Optical Coherence Tomography Angigraphy, Retinal Artery Occlusion, Retrobulbar anesthesiaAbstract
Introduction: Retro-bulbar block is still safe and widely employed anesthetic technique in large volume routine cataract surgery. Nevertheless, the procedure is not free of complication. Case report: A 48 years old man who had small incision cataract surgery of left eye under retro-bulbar block, had vision of hand movement close to face on his first postoperative day. He was given intracameral cefuroxime and subconjunctival gentamycin at the end of the surgery. Fundoscopy of the operated eye showed marked retinal whitening with cherry-red spot in the posterior pole suggestive of cilio-retinal artery occlusion. Optical coherence tomography and optical coherence tomography angiography were done to support and confirm the diagnosis. Conclusion: Retinal artery occlusion secondary to retro-bulbar block or drug induced toxicity following routine cataract surgery is unusual and sometimes dreadful vision threatening complication can occur.
Downloads
References
Katsev DA, Drews RC, Rose BT. An anatomic study of retrobulbar needle path length. Ophthalmology 1989;96(8):1221 4. DOI: https://doi.org/10.1016/s0161-6420(89)32748-5
Jung EH, Park KH, Woo SJ. Iatrogenic central retinal artery occlusion following retrobulbar anesthesia for intraocular surgery. Korean J Ophthalmol. 2015;29(4):233 40. PMID:26240507 DOI: https://doi.org/10.3341/kjo.2015.29.4.233
Vasavada D, Bhaskaran P, Seema R. Retinal Vascular Occlusion Secondary to Retrobulbar Injection: Case Report and Literature Review. Middle East Afr J Ophthalmol. 2017;24(1)57-60. PMID: 28546695 DOI: https://doi.org/10.4103/meajo.meajo_37_16
Klein ML, Jampol LM, Condon PI, Rice TA, Serjeant GR. Central retinal artery occlusion without retrobulbar hemorrhage after retrobulbar anesthesia. American Journal of Ophthalmology. 1982;93(5):573-7. DOI: https://doi.org/10.1016/S0002-9394(14)77371-4
Körner-Stiefbold U. Central retinal artery occlusion (CRAO) - etiology, clinical signs and management. Therapeutic Umschau. 2001;58(1):36-40. DOI: https://doi.org/10.1024/0040-5930.58.1.36
Morgan CM, Schatz H, Vine AK, Davidorf FH, Gitter KA, Rudich R. Ocular complications associated with retrobulbar injections. Ophthalmology.1988;95(5):660 5. PMID: 3174025 DOI: https://doi.org/10.1016/s0161-6420(88)33130-1
Yorston D. Using intracameral cefuroxime as a prophylaxis for endophthalmitis. Community Eye Health. 2008;21(65):11. PMID: 18504469 PMCID: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2377382/
Fintelmann RE, Naseri A. Prophylaxis of postoperative endophthalmitis following cataract surgery: current status and future directions. Drugs. 2010;70(11):1395- 409. PMID: 20614947 DOI: https://doi.org/10.2165/11537950-000000000-00000
Campochiaro PA, Conway BP. Aminoglycoside Toxicity - - A Survey of Retinal Specialists: Implications for Ocular Use. Arch Ophthalmol.1991;109(7):946-50. PMID: 2064573 DOI: https://doi.org/10.1001/archopht.1991.01080070058035
Murao F, Kinoshita T, Katome T, Sano H, Niki M, Mitamura Y. Suspected Gentamicin-Induced Retinal Vascular Occlusion after Vitrectomy. Case Reports Ophthalmology. 2020;11(2):473- 80. DOI: https://doi.org/10.1159/000509337
Cardascia N, Boscia F, Furino C, Sborgia L. Gentamicin-induced macular infarction in transconjunctival sutureless 25-gauge vitrectomy. Int Ophthalmol. 2008;28(5):383-5. PMID: 17938870 DOI: https://doi.org/10.1007/s10792-007-9148-4
Quresh F, Clark D. Macular infarction after inadvertent intracameral cefuroxime. Journal of Cataract and Refractive Surgery. 2011;37(6):1168-9. DOI: https://doi.org/10.1016/j.jcrs.2011.03.032
Downloads
Published
Issue
Section
License
- The Journal of Lumbini Medical College (JLMC) publishes open access articles under the terms of the Creative Commons Attribution (CC BY) License which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- JLMC requires an exclusive licence to publish the article first in its journal in print and online.
- The corresponding author should read and agree to the following statement before submission of the manuscript for publication,
- License agreement
- In submitting an article to Journal of Lumbini Medical College (JLMC) I certify that:
- I am authorized by my co-authors to enter into these arrangements.
- I warrant, on behalf of myself and my co-authors, that:
- the article is original, has not been formally published in any other peer-reviewed journal, is not under consideration by any other journal and does not infringe any existing copyright or any other third party rights;
- I am/we are the sole author(s) of the article and have full authority to enter into this agreement and in granting rights to JLMC are not in breach of any other obligation;
- the article contains nothing that is unlawful, libellous, or which would, if published, constitute a breach of contract or of confidence or of commitment given to secrecy;
- I/we have taken due care to ensure the integrity of the article. To my/our - and currently accepted scientific - knowledge all statements contained in it purporting to be facts are true and any formula or instruction contained in the article will not, if followed accurately, cause any injury, illness or damage to the user.
- I, and all co-authors, agree that the article, if editorially accepted for publication, shall be licensed under the Creative Commons Attribution License 4.0. If the law requires that the article be published in the public domain, I/we will notify JLMC at the time of submission, and in such cases the article shall be released under the Creative Commons 1.0 Public Domain Dedication waiver. For the avoidance of doubt it is stated that sections 1 and 2 of this license agreement shall apply and prevail regardless of whether the article is published under Creative Commons Attribution License 4.0 or the Creative Commons 1.0 Public Domain Dedication waiver.
- I, and all co-authors, agree that, if the article is editorially accepted for publication in JLMC, data included in the article shall be made available under the Creative Commons 1.0 Public Domain Dedication waiver, unless otherwise stated. For the avoidance of doubt it is stated that sections 1, 2, and 3 of this license agreement shall apply and prevail.
Please visit Creative Commons web page for details of the terms.
