Perioperative vision loss after sequential lower extremity fracture surgery: a case report
Ruimin Luo1, Liji Lu1, Yuyuan You1
1Department of Anesthesiology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong 528000, P.R. China.
The Journal of International Medical Research
|November 28, 2024
Summary
Perioperative vision loss (POVL) is rare after lower extremity surgery. This case highlights cautious use of tranexamic acid in hypercoagulable patients to prevent vision complications.
Area of Science:
- Ophthalmology
- Orthopedic Surgery
- Anesthesiology
Background:
- Perioperative vision loss (POVL) is a rare complication, typically associated with cardiac or prone spinal surgeries.
- POVL following lower extremity surgery is exceptionally uncommon, presenting a diagnostic and management challenge.
Observation:
- A case of POVL is reported in a male patient in his mid-thirties following a third surgery for a lower extremity fracture.
- The patient experienced vision loss three hours postoperatively after receiving tranexamic acid during a hypercoagulable state.
Findings:
- Prompt administration of anticoagulant, antithrombotic agents, and high-dose steroid pulse therapy led to vision recovery within three days.
- No abnormalities were detected during a six-month follow-up period, indicating a favorable outcome.
Implications:
- This case underscores the importance of vigilance for POVL in patients with a high risk of thrombosis undergoing lower extremity surgery.
- Careful management of the coagulation system and judicious use of pro-thrombotic medications like tranexamic acid are crucial for preventing POVL.
