Jung Youn Kim1, Yong Girl Rhee2. 1. Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea. 2. Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea. shoulderrhee@hanmail.net.
Abstract
PURPOSE: During shoulder surgery in the beach-chair position, head fixation can sometimes cause rare complications. The authors share their experience in treating ocular injury due to improper head fixation during surgery in the beach-chair position. METHODS: The study investigated consecutively 6075 patients who underwent shoulder surgery in the beach-chair position between March 2007 and March 2016, those patients who saw an ophthalmologist with a complaint of post-operative ocular discomfort. In the beach-chair position, surgery is performed with the patient's upper body raised by 70°. RESULTS: A total of seven patients saw an ophthalmologist due to post-operative ocular discomfort, and a total of five patients (0.082%) had corneal abrasion. Three of these patients underwent arthroscopic surgery, and the other two underwent open surgery. The mean surgery duration for the five patients was 45.0 ± 14.68 minutes. Of these patients, four were male and one was female, and their average age was 46 ± 22.24 years (range: 18-69 years). All patients complained of unbearable ophthalmodynia immediately after surgery that was not resolved using analgesics. The ophthalmodynia resolved immediately after wearing corneal protective lenses. CONCLUSION: Unlike typical surgery, when shoulder surgery is performed in the beach-chair position, there is a risk of ocular surface injury due to improper head fixation; one manifestation of this problem is corneal injury. If a severe ophthalmodynia that cannot be controlled using analgesics occurs immediately after surgery in the beach-chair position, a corneal injury should be suspected, and the patient should wear a corneal protective lens. LEVEL OF EVIDENCE: Level IV.
PURPOSE: During shoulder surgery in the beach-chair position, head fixation can sometimes cause rare complications. The authors share their experience in treating ocular injury due to improper head fixation during surgery in the beach-chair position. METHODS: The study investigated consecutively 6075 patients who underwent shoulder surgery in the beach-chair position between March 2007 and March 2016, those patients who saw an ophthalmologist with a complaint of post-operative ocular discomfort. In the beach-chair position, surgery is performed with the patient's upper body raised by 70°. RESULTS: A total of seven patients saw an ophthalmologist due to post-operative ocular discomfort, and a total of five patients (0.082%) had corneal abrasion. Three of these patients underwent arthroscopic surgery, and the other two underwent open surgery. The mean surgery duration for the five patients was 45.0 ± 14.68 minutes. Of these patients, four were male and one was female, and their average age was 46 ± 22.24 years (range: 18-69 years). All patients complained of unbearable ophthalmodynia immediately after surgery that was not resolved using analgesics. The ophthalmodynia resolved immediately after wearing corneal protective lenses. CONCLUSION: Unlike typical surgery, when shoulder surgery is performed in the beach-chair position, there is a risk of ocular surface injury due to improper head fixation; one manifestation of this problem is corneal injury. If a severe ophthalmodynia that cannot be controlled using analgesics occurs immediately after surgery in the beach-chair position, a corneal injury should be suspected, and the patient should wear a corneal protective lens. LEVEL OF EVIDENCE: Level IV.
Authors: M P Upadhyay; P C Karmacharya; S Koirala; D N Shah; S Shakya; J K Shrestha; H Bajracharya; C K Gurung; J P Whitcher Journal: Br J Ophthalmol Date: 2001-04 Impact factor: 4.638