BACKGROUND: Perioperative visual loss is one of the rare but devastating complications of anesthesia and surgery. The incidence of less severe or even subclinical postoperative visual dysfunction is unknown. Therefore, we decided to perform a pilot prospective observational clinical study to evaluate whether structural changes of the retina can be detected in patients undergoing elective orthopaedic surgery by optical coherence tomography (OCT). METHODS: Adult patients indicated for elective knee replacement surgery with the absence of known retinal or optic nerve disease were included. Each patient underwent baseline OCT examination of the eyes one day before surgery and it was repeated 4-7 days after the surgery. The surgery was done under general and epidural anesthesia. RESULTS: A total of 18 patients (6 men and 12 women) at the age of 70.8±7.1 years were enrolled. We found statistically significant changes in the Macular central thickness and in a few areas of the Retinal Nerve Fiber Layer between the baseline and postoperative measurements. CONCLUSIONS: Even though we found significant changes in some parameters, we did not confirm that general anesthesia and/or surgical damage causes significant damage of the retina using OCT measurement. TRIAL REGISTRATION: ClinicalTrials.gov (NCT04311801).

Department of Anesthesia Pain Management and Perioperative Medicine Dalhousie University Halifax Nova Scotia B3H 4R2 Canada

Department of Anesthesiology and Intensive Care Faculty of Medicine Charles University in Hradec Kralove and University Hospital Hradec Kralove Sokolska 581 Hradec Kralove 500 05 Czech Republic

Department of Anesthesiology Perioperative Medicine and Intensive Care J E Purkinje University Masaryk Hospital Usti nad Labem Socialni pece 3316 12A Usti nad Labem 400 11 Czech Republic

Department of Nursing and Midwifery Faculty of Health Studies J E Purkinje University Pasteurova 3544 1 Usti nad Labem 400 96 Czech Republic

Department of Ophtalmology J E Purkinje University Masaryk Hospital Usti nad Labem Socialni pece 3316 12A Usti nad Labem 400 11 Czech Republic

Department of Research and Development Faculty of Medicine Charles University in Hradec Kralove and University Hospital Hradec Kralove Sokolska 581 Hradec Kralove 500 05 Czech Republic

Department of Surgery Faculty of Medicine Charles University in Hradec Kralove and University Hospital Hradec Kralove Simkova 870 Hradec Kralove 500 03 Czech Republic

Emergency Medical Service of the Central Bohemian Region Vancurova 1544 Kladno 272 01 Czech Republic

Emergency Medical Service of the Usti Region Socialni Pece 799 71 Usti nad Labem 400 11 Czech Republic

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ClinicalTrials.gov
NCT04311801