Acute Onset Ocular Hypotony after Coronary Artery Bypass Surgery. 2017

Sarah Farukhi Ahmed, and Audrey Xi Tai, and Mason Schmutz, and John Combs, and Sameh Mosaed
Gavin Herbert Eye Institute and University of California, Irvine School of Medicine, Irvine, CA, USA.

OBJECTIVE The purpose of this case report is to evaluate risk factors associated with post-coronary artery bypass graft (CABG) ocular hypotony compared to post-CABG ischemic optic neuropathy. METHODS The patient described here is a single case at the University of California, Irvine Medical Center, from July 2016. This case demonstrates the rare incidence of acute post-CABG ocular hypotony and vision loss in a patient with prior history of optic atrophy. Both vision loss and hypotony resolved completely to baseline without intervention within 3 days postoperatively. CONCLUSIONS Severe anemia and large fluctuations in central venous pressure and blood pressure can occur in any patient undergoing CABG surgery. These hemodynamic shifts can cause transient ischemia to pressure controlling systems such as the ciliary body and reduce episcleral venous pressure. Other risk factors for acute hypotony in the setting of CABG surgery also include the use of hypertonic agents, cardiopulmonary bypass, and intravenous anesthesia.

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