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Visual acuity after retrobulbar anesthesia.

M L Levin1, P S O'Connor

  • 1University of Texas Health Science Center, San Antonio.

Annals of Ophthalmology
|September 1, 1989
PubMed
Summary
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During cataract surgery, most patients can still see instruments despite retrobulbar anesthesia. This anesthesia reduces vision and eye movement but does not cause complete blindness.

Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Surgical Science

Background:

  • Intraocular surgery, specifically cataract extraction, often involves retrobulbar anesthesia.
  • Patients undergoing such procedures sometimes report visual awareness of surgical instruments.

Purpose of the Study:

  • To investigate visual acuity, ocular motility, and pupillary response in patients before, during, and after retrobulbar anesthesia for cataract extraction.
  • To determine the extent of visual perception and motor function during the procedure.

Main Methods:

  • Assessed 26 consecutive patients undergoing cataract extraction with retrobulbar anesthesia.
  • Evaluated visual acuity, ocular motility, and pupillary response at multiple time points: pre-injection, during surgery, and post-anesthesia.

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Main Results:

  • 19% of patients had visual acuity better than 6/200 twenty minutes post-injection.
  • 73% of patients perceived instrument movements during surgery.
  • 8% recognized ceiling details post-intraocular lens insertion.
  • 31% exhibited an afferent pupillary defect.

Conclusions:

  • Retrobulbar anesthesia significantly reduces ocular motility and visual acuity but does not induce complete akinesia or blindness.
  • Transient afferent pupillary defect is a potential incidental finding following retrobulbar anesthesia.
  • Patients undergoing cataract surgery with retrobulbar anesthesia may retain partial visual awareness.