Unilateral postoperative visual loss in a patient undergoing hip arthroscopy in the supine position: a case report

Abstract

Micro-emboli have been reported to occur commonly during arthroscopic surgery, which is frequently performed as an orthopedic surgical procedure. We here report a patient who experienced unilateral postoperative visual loss after a hip arthroscopy using irrigation fluid in the supine position without any evidence of external compression to either eye throughout the surgical procedure. Retinal fundoscopy suggested that the patient had central retinal artery occlusion, one of the causes of the postoperative visual loss. This case suggests that arthroscopic surgery may pose a substantial risk for paradoxical air embolism, such as central retinal artery occlusion, and suggests the need to prevent the entry of micro-air bubbles during such a type of surgery.

Keywords: Air embolism; Arthroscopy; Postoperative period; Retinal artery occlusion; Visual loss.

Fig. 1. A postoperative retinal fundoscopy shows cherry-red spot in the macula (astrix) and surrounding ischemic retina (arrows).