Clinical Observations of Transitory Amaurosis Following Minimally Invasive Vitrectom
Objective To analyze the causes and treatment effects of transitory amaurosis following minimally in-vasive vitrectomy.Methods Retrospective case study.with transient acuity after minimally invasive vitrectomy in our hos-pital from November 2019 to November 2022 were included in the study.Among the patients,20 males(22 eyes)and 9 fe-males(9 eyes),ranged in age from 21 to 73 years,with a mean age of(47.62±13.64)years.All patients underwent preop-erative best-corrected visual acuity(BCVA),intraocular pressure,slit lamp microscope,A/B ultrasound,indirect oph-thalmoscopy and/or three-mirror lens,and visual electrophysiology examinations.Among the patients,2 patients(2 eyes)had proliferative diabetic retinopathy,2 patients(2 eyes)had vitreous hemorrhage due to retinal vein occlusion confirmed before or after the surgery,10 patients(11 eyes)had rhegmatogenous retinal detachment,10 patients(11 eyes)had sili-cone oil tamponade,2 patients(2 eyes)had vitreous hemorrhage or endophthalmitis due to ocular trauma,and 3 patients(3 eyes)had dislocated intraocular lens.7 patients(9 eyes)had only one functional eye.6 patients(17 eyes)had high myopia.Systemic comorbidity included 4 cases of hypertension,3 cases of diabetes,1 case of diabetes and hypertension,1 case of HIV positive,1 case of nephritis,1 case of duodenal ulcer,1 case of rheumatoid arthritis and 1 case of marfan's syndrome,while the remaining 1 cases had no specific systemic history.All patients met the indications for vitrectomy and underwent the procedure.Surgery was performed under local anesthesia.Light perception was clear after retrobulbar anes-thesia,but no light perception was observed at the end of the surgery.Various measures,including sublingual nitroglyc-erin,oxygen inhalation,intravenous dexamethasone sodium phosphate injection and energy mixture,and eyeball mas-sage,were applied.Light perception was restored in all patients within 15 to 185 minutes.The possible causes of loss of light perception during surgery were analyzed,and the time to restoration of light perception was observed.Patients were followed up for 6 months to 1 year to observe the impact of temporary postoperative amaurosis on final visual function,the stability of the primary lesion,and the occurrence of related complications.Results At the end of vitrectomy,7 eyes had infusion fluid tamponade,8 had air tamponade,3 had long-acting gas(C3F8)tamponade,and 13 had silicone oil tampon-ade.The time to restore light perception was 15 to 185 minutes postoperatively.Conclusions Transitory amaurosis follow-ing minimally invasive vitrectomy is related to many factors.Severe vitreoretinal diseases,complex surgical procedures,in-traoperative intraocular pressure fluctuations,multiple surgeries,high myopia,optic atrophy,and retinal microcirculation disorders caused by systemic microcirculatory diseases(such as diabetes and hypertension)are all risk factors.Early de-tection and aggressive treatment can restore vision and avoid serious consequences.
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