Cardiac arrest during cornea transplant surgery

Area of Science:

• Ophthalmology
• Cardiology
• Anesthesiology

Background:

• Femtosecond laser enabled penetrating keratoplasty (FLEK) is a common corneal transplant procedure.
• Intraocular surgeries, while generally safe, carry potential systemic risks.
• General anesthesia in young, healthy individuals typically has a low risk profile.

Observation:

• A 22-year-old male patient with no prior cardiac history experienced bradycardia and cardiac arrest during a repeat FLEK procedure under general anesthesia.
• The event occurred during the 'open sky' phase of the surgery.
• The patient was successfully resuscitated, and the corneal transplant was completed.

Findings:

• The patient recovered well post-resuscitation and surgery.
• The corneal graft remained viable with excellent uncorrected visual acuity one year after the procedure.
• This case demonstrates a rare but serious complication during an otherwise standard ophthalmic procedure.

Implications:

• Understanding and communicating the risk of cardiac arrest during intraocular surgery is crucial for preoperative informed consent.
• Anesthesiologists and ophthalmic surgeons must remain vigilant for potential systemic complications even in young, healthy patients.
• Further research may be warranted to identify potential triggers or preventative measures for intraocular surgery-related cardiac events.