Anaesthesia-related diplopia after cataract surgery
Anaesthesia-related diplopia after cataract surgery
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DOI：
10.1093/bja/aeg029
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发表时间：
2003-02-01
影响因子：
9.8
通讯作者：
Arias, A
中科院分区：
文献类型：
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作者：
Gómez-Arnau, JI;Yangüela, J;Arias, A
背景我们研究了综合医院白内障手术麻醉相关的持续性复视的发生率和临床特征。本文对3587例白内障手术麻醉进行回顾性分析。在白内障手术后眼球运动门诊就诊的所有复视病例中，对麻醉相关复视持续时间超过1个月的病例进行了研究。在研究期间，3450例白内障手术采用超声乳化术，137例采用囊外摘除术。球后阻滞2024例，球周阻滞98例，表面麻醉1420例，全身麻醉43例。发现26例持续性复视（发生率0.72%），其中9例（0.25%）被认为与麻醉因素有关;后者中有5例涉及左眼。5例由下直肌麻痹引起，3例由纤维化引起。在1例患者中，下斜肌受到影响。麻醉方法球后阻滞8例（0.39%），球周阻滞1例。表面麻醉或全身麻醉的患者无复视。两名患者接受了手术治疗，六名患者接受了棱镜治疗。1例患者继续接受研究。持续性复视可发生在使用球后阻滞的白内障手术后，主要是通过直接损伤下直肌。麻醉相关复视的总发生率为0.25%。
Background. We studied the incidence and clinical characteristics of persistent diplopia related to anaesthesia for cataract surgery in a general hospital.Methods. This was a retrospective review of anaesthesia for 3587 cataract surgeries. Of all the cases of diplopia referred to the ocular motility clinic after cataract surgery, those involving anaesthesia-related diplopia lasting longer than I month were studied.Results. During the study period, 3450 cataract surgeries were performed by phacoemulsification and 137 by extracapsular extraction. Retrobulbar block was used in 2024 cases, peribulbar block in 98, topical anaesthesia in 1420 and general anaesthesia in 43. Twenty-six cases of persistent diplopia were found (0.72% incidence), nine of which (0.25%) were considered to be related to anaesthetic factors; five of the latter involved the left eye. Five were caused by paresis of the inferior rectus muscle and three by fibrosis. In one patient, the inferior oblique muscle was affected. Anaesthesia was by retrobulbar block in eight cases (0.39%) and by peribulbar block in one. No diplopia was found in patients who had topical or general anaesthesia. Treatment was with surgery in two patients and with prisms in six. One patient continues to be studied.Conclusions. Persistent diplopia can occur after cataract surgery using retrobulbar block predominantly through direct damage to the inferior rectus muscle. The overall incidence of anaesthesia-related diplopia in this series was 0.25%.