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Oculocardiac reflex during laser in situ keratomileusis
Journal of Cataract and Refractive Surgery
|October 31, 1998
Summary
Oculocardiac reflex, a drop in heart rate, occurred in 20% of patients during laser in situ keratomileusis (LASIK). Another 20% experienced heart rate increases due to surgical stress during the procedure.
Area of Science:
- Ophthalmology
- Cardiology
- Surgical Physiology
Background:
- The oculocardiac reflex is a well-documented phenomenon involving cardiac rate changes during ocular manipulation.
- Understanding its incidence during refractive surgery like LASIK is crucial for patient safety.
Purpose of the Study:
- To investigate the occurrence and characteristics of the oculocardiac reflex during laser in situ keratomileusis (LASIK).
Main Methods:
- A prospective study involving 20 patients undergoing LASIK.
- Electrocardiograms (ECG) were recorded pre-procedure, during, and post-procedure.
- Heart rate was monitored during key surgical steps: preparation, microscope light, blepharostat, suction, and laser treatment.
Main Results:
- A decrease in heart rate, indicative of oculocardiac reflex, was observed in 20% of patients during the suction phase.
- Two of these patients experienced a significant heart rate drop of 30% from baseline.
- An increase in heart rate, attributed to surgical stress, occurred in 20% of patients before suction application.
Conclusions:
- Electrocardiographic changes consistent with the oculocardiac reflex were present in 20% of patients during LASIK.
- An additional 20% exhibited heart rate increases, likely due to surgical stress rather than reflex.
- These findings highlight the importance of cardiac monitoring during LASIK procedures.