Unilateral postoperative visual loss after percutaneous nephrolithotomy: a case report.

Area of Science:

• Nephrology
• Ophthalmology
• Interventional Radiology

Background:

• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stones.
• Postoperative visual loss (POVL) is a rare complication of non-ocular surgeries, particularly PCNL.
• Patients with hypertension and diabetes are at increased risk.

Observation:

• A 60-year-old male with hypertension and type 2 diabetes developed unilateral vision loss post-PCNL.
• Ophthalmologic evaluation confirmed severe vision impairment and ophthalmic artery occlusion.
• The patient underwent PCNL in the prone position.

Findings:

• Imaging revealed right ophthalmic artery occlusion as the cause of POVL.
• A multidisciplinary team intervened promptly with intra-arterial thrombolysis.
• Restoration of blood flow resulted in gradual visual function recovery.

Implications:

• This case highlights ophthalmic artery occlusion as a rare but serious complication of PCNL.
• Early recognition and swift, coordinated multidisciplinary intervention are crucial for visual recovery.
• Clinicians must maintain vigilance for POVL in patients undergoing prone-position surgeries, especially those with risk factors.