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. 2024 Apr;73(4):279-290.
doi: 10.1007/s00101-024-01398-1.

[Perioperative visual loss : Rare, unknown, relevant?]

[Article in German]
Nicolina Michels  1 , Raffaella Fantin  2
Affiliations

[Perioperative visual loss : Rare, unknown, relevant?]

[Article in German]
Nicolina Michels et al. Anaesthesiologie. 2024 Apr.

Abstract
in English, German

Perioperative visual loss (POVL) is a rare but severe complication following non-ophthalmological surgery under general anesthesia. A POVL can be caused by lesions in any part of the optical system. The predominant causes include corneal injuries and particularly ischemic damage. The symptoms of POVL substantially vary ranging from reduced vision to complete blindness. The risks involve factors related to the surgery as well as patient-specific factors. In general, the prognosis in cases of mechanical damage is better than for ischemic lesions. The treatment measures depend on the underlying pathomechanism and due to the limited evidence only a few treatment options are available. Therefore, preventive measures and meticulous documentation play a crucial role.

Der perioperative Visusverlust (POVL) ist eine seltene, aber schwerwiegende Komplikation nach nichtophthalmologischen Operationen unter Allgemeinanästhesie. Ein POVL kann durch Läsionen in jeglichen Abschnitten des optischen Systems verursacht werden. Zu den vorherrschenden Ursachen zählen neben Hornhautverletzungen v. a. ischämische Schädigungen. Die Symptome variieren erheblich und reichen von einer Sehminderung bis zur kompletten Erblindung. Die Risiken umfassen sowohl operationsbedingte als auch patientenspezifische Faktoren. Im Allgemeinen ist die Prognose bei mechanischen Schäden besser als bei ischämischen Läsionen. Die Behandlungsmaßnahmen richten sich nach dem vorliegenden Pathomechanismus, wobei aufgrund der geringen Evidenzlage nur wenige Therapieansätze vorliegen. Präventive Maßnahmen und eine sorgsame Dokumentation sind deshalb von entscheidender Bedeutung.

Keywords: Corneal injuries; Cortical blindness; General anesthesia; Ischemic optic neuropathy; Retinal artery occlusion.

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References

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