Our Summary

This research paper looks into a specific kind of eye damage that can happen after eye surgery. This damage, called paracentral acute middle maculopathy (PAMM), was observed in nine cases over a nine-year period (2011-2020).

The researchers noticed that all nine cases had something in common: they all had reduced vision a day after their surgery. Using different imaging techniques, they found a bright band in the middle layers of the retina at first, which later turned into thinning and deterioration of these layers. They also noticed that the blood flow in the retina was affected.

The researchers believe that this might happen because of the local anaesthetic used during surgery. The anaesthetic might cause the blood vessels in the eye to constrict, an increase in eye pressure, and a mechanical effect due to the volume of anaesthetic injected. This could lead to reduced blood flow in the retina, which might appear as PAMM in the scans.

The researchers conclude that PAMM could be a potential risk of using local anaesthetic during eye surgery, especially in cases where vision loss occurs unexpectedly after the surgery. However, the level of vision recovery varied between patients.

FAQs

  1. What is paracentral acute middle maculopathy (PAMM) and how is it related to eye surgery?
  2. What do the researchers believe might be causing PAMM after ocular surgery?
  3. Does the use of local anaesthetic during eye surgery always lead to PAMM?

Doctor’s Tip

One helpful tip a doctor might give to a patient undergoing ocular surgery is to closely monitor their vision after the procedure. If they notice any sudden changes or reduction in vision, it is important to contact their doctor immediately. Early detection and treatment of any complications, such as PAMM, can help prevent further damage and improve the chances of vision recovery. It is also important for patients to follow their doctor’s post-operative care instructions and attend all follow-up appointments to ensure proper healing and recovery.

Suitable For

Patients who are recommended for ocular surgery typically have conditions such as cataracts, glaucoma, retinal detachment, diabetic retinopathy, macular degeneration, and other eye disorders that require surgical intervention to improve vision or prevent further damage to the eye. Patients who experience sudden vision loss or other complications after eye surgery may require further evaluation to determine the cause and appropriate treatment.

Timeline

Before ocular surgery:

  1. Patient consults with an ophthalmologist to discuss the need for surgery and potential risks and benefits.
  2. Patient undergoes pre-operative testing and evaluation to assess the health of the eye and overall suitability for surgery.
  3. Patient receives instructions on pre-operative care, such as avoiding certain medications or foods before surgery.

After ocular surgery:

  1. Patient undergoes the surgical procedure, which may involve local or general anaesthesia.
  2. Patient may experience some discomfort or blurry vision immediately after surgery.
  3. Patient is monitored by medical staff for any complications or side effects following the procedure.
  4. Patient may be prescribed medications to manage pain or prevent infection.
  5. Patient follows post-operative care instructions, such as using eye drops, wearing protective eyewear, and attending follow-up appointments.
  6. Patient gradually recovers vision over time, with some patients experiencing temporary or permanent changes in vision.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the specific ocular surgery I am considering?

  2. How common is paracentral acute middle maculopathy (PAMM) after this type of surgery?

  3. What are the symptoms of PAMM, and how can it be diagnosed?

  4. What imaging techniques are used to detect PAMM?

  5. How is PAMM treated, and what is the expected outcome for vision recovery?

  6. Are there any preventive measures that can be taken to reduce the risk of developing PAMM after surgery?

  7. Are there alternative anesthesia options that could lower the risk of developing PAMM?

  8. How will my post-operative care plan be tailored to monitor for any signs of PAMM or other complications?

  9. What is the likelihood of experiencing vision loss after this surgery, and what are the possible causes?

  10. Can you provide any additional resources or information about PAMM for further understanding?

Reference

Authors: Bernal-Morales C, Velazquez-Villoria D, Cubero-Parra JM, Keane PA, Sim DA, Adán A, Tufail A, Zarranz-Ventura J. Journal: Eye (Lond). 2022 Jan;36(1):219-227. doi: 10.1038/s41433-021-01481-6. Epub 2021 Mar 8. PMID: 33686235