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Correlation between sub-Tenon’s anesthesia and transient amaurosis during ophthalmic surgery

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To verify the correlation between sub-Tenon’s anesthesia and intraoperative visual loss in ophthalmic surgery.


Sixty-four patients underwent phacoemulsification combined pars plana vitrectomy under sub-Tenon’s anesthesia. Participants were investigated about their light perception at several time points: before anesthesia, immediately after anesthesia, 10 min after anesthesia without any surgical intervention or microscope illumination, and after the whole surgery. Intraoperative amaurosis was determined as that a patient could not see any light from their operative eye. The incidence rate of amaurosis at different time points and among different anesthetists was analyzed.


The rate of intraoperative amaurosis was 0%, 1.56%, 48.44%, and 95.31% at several time points, respectively: before anesthesia, immediately after anesthesia, 10 min after anesthesia without any surgical intervention or microscope light exposure during the interval, and immediately after the whole surgery, presenting a significantly time-dependent increase (P < 0.01). There was no correlation between the amaurosis and different diseases and anesthesiologists. The amaurosis was transient, and all operative eyes could perceive light on the first postoperative day.


Sub-Tenon’s anesthesia contributes to the intraoperative amaurosis during operation. Temporary interruption of optic nerve conduction by the anesthetic could be a credible explanation. The amaurosis is transient and reversible, requires no additional treatment, and should not be considered as a surgical complication.

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The study was funded by the Foundations of Innovation and Strong School Project of Shantou University Medical College and Medical and Health Technology Plan of Shantou (NO. 180726214011420), the Science and Technology Planning Project of Guangdong Province of China (NO. 2011B031800369), and the Science and Technology Planning Project of Shantou City (NO. 2018–027) by Weiqi Chen.

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Yi Shi, Zijing Huang, and Weiqi Chen. The first draft of the manuscript was written by Yi Shi, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Weiqi Chen.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Joint Shantou International Eye Center (JSIEC) Ethic Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Shi, Y., Huang, Z., Chen, W. et al. Correlation between sub-Tenon’s anesthesia and transient amaurosis during ophthalmic surgery. Int Ophthalmol 40, 1955–1962 (2020).

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