Ocular surface injury after shoulder surgery in the beach-chair position

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...

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Bibliographic Details
Published in:International orthopaedics 2018-12, Vol.42 (12), p.2891-2895
Main Authors: Kim, Jung Youn, Rhee, Yong Girl
Format: Article
Language:English
Subjects:
Adult
Aged
Arthroscopy
Eye - pathology
Eye Injuries
Female
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Original Paper
Orthopedics
Patient Positioning
Postoperative Period
Shoulder - surgery
Shoulder Joint - surgery
Young Adult
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Summary: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
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-018-4044-2