Eye Injuries After Nonocular Surgery
27 Jul 2007
A Study of 60,965 Anesthetics from 1988 to 1992
Abstract of Article Published in:
Anesthesiology
1996; 85:1020-7
Steven Roth, M.D. Associate Professor of Anesthesia and Critical Care; Chief, Neuroanesthesia. Ronald A. Thisted, Ph.D. Professor of Anesthesia and Critical Care, Statistics, Clinical Pharmacology, and Professor in the College. John P. Erickson, M.D. Assistant Professor of Anesthesia and Critical Care. Susan Black, M.D. Assistant Professor of Anesthesia and Critical Care. Bruce D. Schreider, M.D., Ph.D. Associate Professor of Clinical Anesthesia and Critical Care. Current position for Dr. Black: Associate Professor of Anesthesia, University of Florida, Gainesville.
Eye injuries have been reported after anesthesia in surgeries not involving the eye. These eye injuries after anesthesia, although infrequent, have resulted in permanent visual impairment in some cases. Previously reported studies have not defined the risk factors associated with, or apparent causes of, these injuries. In an effort to study the cause of these injuries and to determine how often the eye injuries occurred, the authors reviewed the records from a 4.5-y period of patients who sustained eye injuries after anesthesia in surgery not involving the eye.
The records were surveyed of 60,965 patients who underwent anesthesia for nonocular surgery at a prominent institution from January 1988 to July 1992. Instances of eye injuries were identified through several sources of information, including quality improvement data, postoperative visits or telephone calls, and examination of medical records of postoperative patients who required an ophthalmology consultation. Records were reviewed to determine the types and causes of eye injuries. Statistical methods were used to identify the possible risk factors and their relative importance.
Results: Of 34 patients who sustained eye injuries (0.056%), the most common was corneal abrasion (n = 21). Other injuries were conjunctivitis, blurred vision, red eye, chemical injury, direct trauma, and blindness. The following independent factors associated with a higher relative risk of eye injury were identified: long surgical procedures, lateral positioning during surgery, operation on the head or neck, general anesthesia, and surgery on a Monday. In only 21% of cases was a specific cause of injury identified.
Conclusions: For reasons not understood, eye injuries are more common in patients who are older or who undergo lengthier procedures. The cause of injury was usually not determined by the authors' methods. Until the mechanisms producing perioperative eye injuries are better understood, it is difficult to identify strategies to prevent this type of injury
Received from the Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois. Submitted for publication May 23, 1996. Accepted for publication July 1, 1996. Supported in part by National Institutes of Health grant R01EY10343 to Dr Roth. Presented in part at the annual meeting of the International Anesthesia Research Society, San Diego, CA, March 19-23, 1993.
