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Anterior ischemic optic neuropathy after open heart operations
O M Shapira1, W A Kimmel, P S Lindsey
1Department of Thoracic and Cardiovascular Surgery, Lahey Hitchcock Medical Center, Burlington, Massachusetts 01805, USA.
The Annals of Thoracic Surgery
|February 1, 1996
Summary
An increased incidence of anterior ischemic optic neuropathy (AION) was observed after open heart surgery. Prolonged bypass time and low hematocrit were linked to AION, emphasizing the need for preventative strategies.
Area of Science:
- Ophthalmology
- Cardiovascular Surgery
- Neurology
Background:
- The incidence of anterior ischemic optic neuropathy (AION) after open heart surgery is typically low (<0.5%).
- A notable increase in AION incidence (1.3%) was observed at Lahey Clinic between March 1990 and March 1992.
Purpose of the Study:
- To investigate the increased incidence of AION following open heart operations.
- To identify risk factors and evaluate treatment options for AION.
Main Methods:
- A retrospective analysis of 602 patients who underwent open heart surgery during the specified period.
- Examination of preoperative and perioperative factors associated with AION development.
Main Results:
- No preoperative risk factors for AION were identified.
- AION was associated with prolonged cardiopulmonary bypass, low hematocrit, significant weight gain, and use of epinephrine/amrinone.
- Potential risk factors included hypothermia, anemia, elevated intraocular pressure, and microembolization.
Conclusions:
- Current treatment options for AION have limited success.
- Preventative measures are crucial due to the limited efficacy of treatments.
- Optic nerve fenestration has shown no benefit in recent studies and clinical experience.