| 발표일자: |
2019년 11월 1일(금)~3(일) |
| 발표번호: |
P(e-poster)-014 |
| 발표장소: |
B3 Parking Area
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| 전신마취 하 유방양성종양 수술 후 발생한 양안 급성폐쇄각발작 1예 |
| 경상대학교 의과대학 안과학교실, 창원경상대학교병원 |
| 김범준, 조현경, 강태신, 김지혜, 남기엽, 한용섭, 유지명 |
| 본문 : To report a case of bilateral acute angle closure crisis after general anesthesia for a benign neoplasm of the breast surgery.
A 60-year-old female complained of bilateral ocular pain and visual disturbance after recovering from general anesthesia for wide excision of the left breast operation. Visual acuity was finger count and intraocular pressure (IOP) was measured as 50 mmHg in the right eye and 60 mmHg in the left eye. Slit lamp exam revealed cornea edema, conjunctival injection, and shallow central anterior chamber and narrow peripheral angle in both eyes. Acute angle closure crisis due to anesthetic agent was suspected. The symptoms improved after she was prescribed hypotensive eye drops, acetazolamide, and Osmotic diuretic medication. The next day of the surgery, IOP decreased to 10/10 mmHg and anterior chamber depth was 1.94 mm in the right eye and 1.88 mm in the left eye. Laser iridotomy combined (LI) with laser peripheral iridoplasty (PI) was performed in the left eye. The following day, LI plus PI was also conducted in the fellow right eye. Cup to radio was 0.6/0.7 in fundus photography and superotemporal and inferotemporal retinal nerve fiber layer defect was observed in the left eye on optical coherence tomography. In the left eye, superior and inferior nasal visual field defect was observed, which is corresponding area to RNFL defect on red-free fundus photography and OCT. It indicates glaucomatous injury in the left eye.
It may be necessary to examine the patient for primary angle closure (PAC) and inspect the history of PAC even before non-ocular surgery, especially in patients with risk factors such as old age and female. Careful monitoring is required during the recovery of general anesthesia for ocular symptoms considering the possibility of bilateral acute angle closure crisis.
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