A 75-year-old man with no personal history underwent cataract surgery of his right eye (OD) in our Department.
Before surgery, corrected visual acuity (VA) was 0.3 in both eyes.
The rest of the exploration revealed no other pathological findings.
Preoperatively, the patient received a retrobulbar injection of 4 cc in his right eye, 2 of them with lidocaine (Lidocaine© iny 2% 10 ml, Braun) and other 2 with bupivacaine (Sve).
Phacoemulsification of the right crystalline lens and placement of an acrylic lens (Alcon, Acrysoft© monoblock) of 23 diopters on the posterior capsule without complications were performed.
In the immediate postoperative period, the patient reported not perceiving light through his left eye (LE).
The pupil of this eye was in mid-dilatation and did not react to light.
The patient also had peptic malignant disease, abolished adduction, depression and elevation with ocular anesthesia.
Therefore, it was a dysfunction of cranial nerves II and III.
Funduscopy of this eye was normal.
Cranial nerves IV and VI were intact.
The RE, after the intervention, was also akinetic and anesthetized.
The patient gradually improved his vision.
Four hours after surgery, the VA of the left eye was similar to that presented preoperatively and ocular motility had also normalized.
At approximately 3 weeks after surgery, the VA of the RE (with cylinder -1.5 to 80o) was 0.8 and of the LE 0.3.
Motility was normal in both eyes and isochoric and normoreactive pupils.
