Postoperative Visual Loss: A Report of One Patient With Unilateral Blindness After Orthognathic Surgery

J Craniofac Surg. 2019 Jan;30(1):223-225. doi: 10.1097/SCS.0000000000005151.

Abstract

Introduction: Blindness after orthognathic surgery may be the result of the surgical procedure itself or the consequence of factors induced by general anesthesia. However, the exact mechanism between is not known. The purpose of this article is to present a case of a postoperative visual loss after orthognathic surgery under general anesthesia concluding with a brief literature review about this topic.

Report of case: We report the case of a patient who suffered unilateral blindness with homolateral frontal paresthesia after orthognathic procedure in 2 steps. He presented intraoperative bradycardia with a potential undiagnosed hypertension, associated with significant blood loss and volume resuscitation by colloids and cristalloids.Postoperative examination concluded to posterior ischemic optic neuropathy.

Discussion and conclusion: By a systematic literature review, we discuss about surgical and anesthesic causes of postoperative visual loss, and particularly pathophysiology mechanism of posterior ischemic optic neuropathy. Some predisposition and risk factors have been identified and need to be taken into account.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anesthesia, General / adverse effects
  • Blindness / diagnosis
  • Blindness / etiology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Optic Neuropathy, Ischemic / complications*
  • Optic Neuropathy, Ischemic / diagnosis
  • Optic Neuropathy, Ischemic / physiopathology
  • Orthognathic Surgical Procedures / adverse effects*
  • Postoperative Complications / etiology*
  • Visual Acuity*