Asymptomatic and symptomatic postoperative visual dysfunction after cardiovascular surgery with cardiopulmonary bypass: a small-sized prospective observational study.
OBJECTIVE
Postoperative visual dysfunction (POVD) after cardiovascular surgery rarely is reported, since it is more likely underdetected and underreported. This study was designed to verify the presence of POVD, including a variety of asymptomatic as well as symptomatic visual dysfunctions after cardiovascular surgery with cardiopulmonary bypass (CPB).


METHODS
A prospective observational study.


METHODS
Cardiothoracic surgery in a medical university hospital.


METHODS
Seventy-one patients undergoing elective cardiovascular surgery with CPB.


METHODS
None.


RESULTS
All patients were assessed by a battery of 7 neuro-ophthalmic examinations preoperatively and postoperatively, including fundus, visual field, eye movement, color vision, visual acuity, intraocular pressure, and critical flicker frequency. Patients were considered to have POVD if they had postoperative new abnormal findings of neuro-ophthalmic examinations. One patient was excluded due to a failure of postoperative neuro-ophthalmic examinations. In 16 of 70 patients analyzed in this study, selective cerebral perfusion was required for aortic arch surgery. Of 70 patients, a total of 8 patients (11.4%) had postoperative new abnormal findings in neuro-ophthalmic examinations, including new visual field deficits in 4, reduced visual acuity in 4, and/or increased intraocular pressure in 1 patient. Of these 8 patients, symptomatic POVD was recognized in 1 patient (1.4%) with postoperative visual field deficit and reduced visual acuity. There were no new abnormal findings compared with preoperative results in postoperative funduscopy, eye movement, color vision, and critical flicker frequency.


CONCLUSIONS
These results indicated that the asymptomatic as well as symptomatic POVD can develop after cardiovascular surgery with CPB, and their incidence may be relatively high.
Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan.
Hironobu
H
Hayashi
Masahiko
M
Kawaguchi
Masahiro
M
Okamoto
Kyoko
K
Hasuwa
Toyoaki
T
Matsuura
Shigeki
S
Taniguchi
Hitoshi
H
Furuya
D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D014786:Vision Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology
asymptomatic disease; cardiopulmonary bypass; cardiovascular surgical procedures; ocular; postoperative complication; vision