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Medicinas Complementárias
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1.
J Int Med Res ; 48(5): 300060520925705, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32436475

RESUMEN

OBJECTIVE: Some patients have been found to develop intraoperative amaurosis under sub-Tenon's anesthesia. We explored whether these patients have poor surgical outcomes during mid- to long-term postoperative follow-up. METHODS: In this case series, 74 of 85 patients with macular diseases who underwent phacoemulsification combined with vitrectomy under sub-Tenon's anesthesia developed intraoperative amaurosis. The surgical outcomes at the 2- and 4-month follow-ups in these patients were investigated and compared with the outcomes in patients without amaurosis using best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and pattern visual evoked potential (PVEP). RESULTS: Both BCVA and the OCT-based macular structure in patients with intraoperative amaurosis showed significant postoperative improvement comparable with that of patients without amaurosis. The presence of intraoperative amaurosis was not associated with either macular hole closure or macular edema regression. PVEP revealed no significant changes in the wave latency or amplitude before and after surgery. CONCLUSION: Intraoperative amaurosis following sub-Tenon's block is commonly seen but does not predict a poor surgical prognosis. When a patient develops amaurosis during surgery, the surgeon should increase patient comfort through verbal communication rather than perform an additional intervention to help relieve the patient's anxiety.


Asunto(s)
Anestesia Local/efectos adversos , Ceguera/epidemiología , Complicaciones Intraoperatorias/epidemiología , Bloqueo Nervioso/efectos adversos , Facoemulsificación/efectos adversos , Vitrectomía/efectos adversos , Anestesia Local/métodos , Ceguera/etiología , Ceguera/psicología , Ceguera/rehabilitación , Potenciales Evocados Visuales , Estudios de Seguimiento , Fóvea Central/diagnóstico por imagen , Fóvea Central/cirugía , Humanos , Incidencia , Complicaciones Intraoperatorias/etiología , Complicaciones Intraoperatorias/psicología , Complicaciones Intraoperatorias/rehabilitación , Bloqueo Nervioso/métodos , Facoemulsificación/métodos , Periodo Posoperatorio , Factores Protectores , Perforaciones de la Retina/cirugía , Cápsula de Tenon/inervación , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Vitrectomía/métodos
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