Monocular blindness as a complication of trigeminal radiofrequency rhizotomy.
OBJECTIVE
To raise the awareness of the rare complication of monocular blindness resulting from radiofrequency rhizotomy for trigeminal neuralgia.


METHODS
Case series from tertiary referral centers. Patients were referred after complaint of loss of vision.


RESULTS
We report three patients who had trigeminal neuralgia and underwent treatment by radiofrequency rhizotomy. Each developed complete loss of vision in one eye immediately after the procedure. One patient died of an unrelated cause, and pathologic analysis revealed changes compatible with acute trauma to the right optic nerve.


CONCLUSIONS
Our third case confirms the hypothesis that traumatic optic neuropathy after trigeminal radiofrequency rhizotomy results from malpositioning of the rhizotomy needle through the inferior orbital fissure into the orbital apex rather than the foramen ovale.
Neuro-Ophthalmology Unit, Casey Eye Institute, 3375 Terwilliger Road, Portland, OR 97201, USA. eganr@ohsu.edu
R A
RA
Egan
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Pless
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Shults
D000368:Aged; D001766:Blindness / Q000209:etiology*; D004564:Electrocoagulation / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D020221:Optic Nerve Injuries / Q000209:etiology*; D019051:Rhizotomy / Q000009:adverse effects*; D014277:Trigeminal Neuralgia / Q000601:surgery*; D015349:Vision, Monocular