title: A sudden total loss of vision after routine cataract surgery.
abstract: We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post operative and optic atrophy by 2 months postoperative. This could have been caused by vascular occlusion in an already compromised artherosclerosed vessels. It could also have been due to gentamyin toxicity. Gentamycin injection given subconjunctivally is known to rarely result in severe retinal toxicity. This case illustrates that even though cataract surgery is considerd a simple routine procedure, and is performed in high volumes, it is not without its blinding complications. We recommend that the use of adrenaline in xylocaine should be used with caution in hypertensive patients and also the routine use of subconjunctival gentamycin injection after cataract surgery should be reviewed and other modes of endophthalmitis prophylaxis be considered.
authors: Eye Ear Nose and Throat Department, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. sylartey.chs@knust.edu.gh
authors: S
authors: S
authors: Lartey
authors: P
authors: P
authors: Armah
authors: A
authors: A
authors: Ampong
mesh_terms: D000772:Anesthesia, Local; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001766:Blindness / Q000209:etiology*; D002386:Cataract / Q000150:complications; D002387:Cataract Extraction / Q000009:adverse effects*; D004837:Epinephrine / Q000009:adverse effects; D005260:Female; D005839:Gentamicins / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008012:Lidocaine / Q000009:adverse effects; D008875:Middle Aged; D014662:Vasoconstrictor Agents / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine
references: Int Ophthalmol. 2008 Oct;28(5):383-5
references: 17938870
references: Br J Ophthalmol. 2005 Jun;89(6):719-23
references: 15923508
references: Ophthalmol Clin North Am. 2001 Dec;14(4):611-24
references: 11787741
references: Ophthalmology. 1998 Jun;105(6):1004-10
references: 9627649
references: Arch Ophthalmol. 1994 Jan;112(1):45-7
references: 8285891
references: Arch Ophthalmol. 2008 Apr;126(4):554-6
references: 18413529
references: Acta Ophthalmol. 2012 Mar;90(2):e153- 4
references: 21470387
references: Drugs. 2010 Jul 30;70(11):1395-409
references: 20614947
references: Indian J Ophthalmol. 2000 Jun;48(2):123-8
references: 11116508
references: J Cataract Refract Surg. 2011 Jun;37(6):1168-9
references: 21596262
references: Br J Ophthalmol. 1999 Oct;83(10):1199-200
references: 10636651
references: Invest Ophthalmol Vis Sci. 2005 Dec;46(12):4804-8
references: 16303982
references: Arch Ophthalmol. 1991 Jul;109(7):946-50
references: 2064573