Acute Glaucoma Attack Following Microvascular Decompression Surgery for Trigeminal Neuralgia.

Acute Glaucoma Attack Following Microvascular Decompression Surgery for Trigeminal Neuralgia. Neurol Med Chir (Tokyo). 2018 May 17;: Authors: Amagasaki K, Nagayama M, Watanabe S, Shono N, Nakaguchi H Abstract Microvascular decompression (MVD) is widely accepted as an effective surgical method to treat trigeminal neuralgia (TN), but the risks of morbidity and mortality must be considered. We experienced a case of acute angle-closure glaucoma attack following MVD for TN in an elderly patient, considered to be caused by lateral positioning during and after the surgery. A 79-year-old female underwent MVD for right TN in the left lateral decubitus position, and TN disappeared after the surgery. Postoperatively, the patient tended to maintain the left lateral decubitus position to prevent wound contact with the pillow, even after ambulation. Two days after the surgery, she complained of persistent left ocular pain with visual disturbance. The left pupil was dilated with only light perception, and the intraocular pressure (IOP) was 44 mmHg. Acute angle-closure glaucoma attack was diagnosed. After drip infusion of mannitol, emergent laser iridotomy was performed. The corrected visual acuity recovered with normalization of IOP (14 mmHg). The subsequent clinical course was uneventful and she was discharged from our hospital. The left lateral positioning during and after the surgery was considered to have contributed to increase IOP of the eye ...
Source: Neurologia Medico-Chirurgica - Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research