Anaesthesia Concepts in Patients with Chronic Progressive External Ophthalmoplegia Undergoing Ophthalmic Surgery—A Retrospective Cohort Analysis

TL;DR

This study examines the safety of different anesthesia methods in patients with chronic progressive external ophthalmoplegia undergoing eye surgery.

Contribution

The study provides evidence that both local and general anesthesia can be safely used in CPEO patients for ophthalmic surgery.

Findings

Twelve ophthalmic surgeries were performed in eleven CPEO patients with no relevant complications.

Propofol-based general anesthesia for less than one hour was feasible in CPEO patients.

Local anesthesia was successfully used in six patients without complications.

Abstract

Background: Chronic progressive external ophthalmoplegia (CPEO) belongs to the group of mitochondrial encephalomyopathies. Anaesthesia for patients with CPEO may be associated with an increased risk due to known drug effects on mitochondrial metabolism. Therefore, the aim of this analysis was to evaluate anaesthesiological concepts in patients with CPEO requiring ophthalmic surgery. Methods: This is a retrospective, monocentric cohort analysis of eleven patients with CPEO undergoing ophthalmic surgery either with general anaesthesia or local anaesthesia in a German university hospital from January 2012 to February 2022. Results: A total of twelve ophthalmic surgery procedures were performed in eleven adult patients with CPEO. Six patients underwent surgery after receiving local anaesthesia (LA cohort). Five patients underwent six surgical procedures under general anaesthesia (GA cohort). In five cases within the GA cohort, propofol and remifentanil were used for the maintenance of anaesthesia. In one case, balanced anaesthesia with desflurane and remifentanil was used. The median duration of general anaesthesia was 37.5 min (range, 25–65 min). Patients stayed in the recovery room for a median of 48.5 min (range, 35–70 min). All patients were discharged on the first postoperative day. No relevant complications occurred in either the LA or GA cohort. Conclusion: Both local and general anaesthesia are feasible concepts for patients with CPEO undergoing ophthalmic surgery. Propofol, at least with a short duration (less than one hour) of use, appears to be a feasible hypnotic drug in CPEO patients.