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[The oculocardiac reflex in blepharoplasties].

V Rippmann¹, T Scholz, S Hellmann

¹Evangelisches Krankenhaus Dortmund. rippmann@web.de

Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V

|August 22, 2008

Summary

The oculocardiac reflex (OCR) can occur during blepharoplasty, affecting 20% of patients. Gentle surgical techniques and monitoring are crucial for managing this potentially life-threatening reflex.

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Surgical Correction for Pediatric Epiblepharon and Trichiasis

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Surgical Correction for Pediatric Epiblepharon and Trichiasis

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Published on: July 8, 2025

Area of Science:

Ophthalmology
Anesthesiology
Cardiology

Background:

The oculocardiac reflex (OCR) is a known risk in ophthalmic surgery, characterized by bradycardia due to ocular manipulation.
Historically, OCR has been underreported in aesthetic blepharoplasty procedures, despite potential severe consequences.

Observation:

A case of cardiac arrest during blepharoplasty prompted an investigation into OCR incidence in this specific surgery.
The study reviewed 110 blepharoplasty patients over three years to identify OCR occurrences.

Findings:

The oculocardiac reflex (OCR) was observed in 22% of blepharoplasty patients (22 out of 110).
OCR predominantly affected younger, lower-weight patients undergoing local anesthesia.
Key triggers included ocular manipulation, trigeminal-vagal nerve stimulation, and significant traction on eye muscles or fat pads.

Implications:

Increased awareness and proactive management of OCR are vital for patient safety during blepharoplasty.
Gentle surgical techniques, avoiding excessive traction, can prevent OCR onset.
Releasing tension on ocular structures is the primary treatment for bradycardia caused by OCR, alongside continuous intraoperative monitoring.