Unilateral postoperative visual loss after percutaneous nephrolithotomy: a case report

Postoperative visual loss (POVL) after non-ocular surgeries is rare, and its occurrence following percutaneous nephrolithotomy (PCNL) is exceedingly uncommon. A 60-year-old male with hypertension and type 2 diabetes mellitus underwent PCNL in the prone position for a right renal calculus. Shortly after surgery, he reported unilateral visual loss. Ophthalmologic assessment revealed profound vision impairment in the right eye. Imaging confirmed occlusion of the right ophthalmic artery. A multidisciplinary team including ophthalmology, neurology, and interventional radiology coordinated prompt intervention. Emergency intra-arterial thrombolysis restored blood flow and led to gradual recovery of visual function. This case illustrates a rare but serious complication of POVL due to ophthalmic artery occlusion after PCNL. Prompt recognition and timely multidisciplinary intervention were key to successful visual recovery. Clinicians should remain vigilant for POVL in high-risk patients undergoing prone-position surgeries.