Acute Blindness Occurring during Cataract Surgery Due to Paranasal Sinus Mucocele

鼻竇黏液囊腫造成白內障手術中發生急性眼盲

陳以晟(Yi-Cheng Chen) ； 李佳芸(Chia-Yun Li) ； 呂俊憲(Paul Chung-Shien Lu)

《中華民國眼科醫學會雜誌》 46卷4期 (2007/12) Pp. 450-455

https://doi.org/10.30048/ACTASOS.200712.0010

摘要

目的：鼻竇黏液囊腫在臺灣並非罕見，但是它對眼睛的影響卻常被忽視。本文報告一例因鼻竇黏液囊腫造成病人於白內障手術中發生急性視力喪失的併發症。
方法：觀察性病例報告
結果：這是一位五十七歲男性在接受白內障手術後發現右眼視力喪失，眼部檢查發現其右眼已經無光感。電腦斷層檢查發現在其雙側篩竇及蝶竇有巨大軟組織佔據並且使雙側眼窩壁變形壓迫視神經。雖然於發病二十小時後緊急施行鼻竇內視鏡手術，但是手術後視力仍無法恢復。
結論：因此對於有鼻竇炎病史的病人，最好於白內障手術前先接受鼻竇檢查，必要時先治療鼻竇疾病，以避免手術中併發症發生。

並列摘要

Purpose: Paranasal sinus mucocele is not uncommon in Taiwan, but its damage to the eye is usually overlooked. We report a case of acute blindness caused by paranasal sinus mucocele occurring during cataract surgery.
Method: Observational case report
Result: A 57-year-old man complained of loss of vision in his right eye with his left eye patched immediately after smooth cataract surgery. Ocular examination of his right eye revealed no light perception with afferent pupillary defect. Moderate limitation of abduction was also noted. Computed tomography and magnetic resonance imaging revealed huge soft tissue filling of the bilateral ethmoid and sphenoid sinus with invasion into bilateral orbit and compression of the optic nerve. The tumor also extended to the frontal sinus and sella turcica. Nasal examination showed bulging mucocele from the bilateral ethmoid and sphenoid sinus. Emergent functional endoscopic sinus surgery was performed 20 hours after the onset to decompress the optic nerve. The right eye, however, remained blind after surgery.
Conclusion: Patients with a sphenoid sinus mucocele often experience ophthalmic symptoms only such as visual impairment, external ophthalmoplegia, and diplopia. Ophthalmologists must be alert to these complaints and the history of sinusitis especially during a preoperative evaluation.

並列關鍵字

paranasal sinus mucocele ； rhinogenic optic neuropathy ； cataract surgery