Posterior Ischemic Optic Neuropathy Following Percutaneous Nephrolithotomy

Purpose: To report a case of posterior ischemic optic neuropathy (PION) following percutaneousnephrolithotomy (PCNL).Case Report: A 57-year-old man with history of diabetes mellitus, hyperlipidemia andmild anemia underwent PCNL for treatment of nephrolithiasis. He noticed painlessvisual loss in both eyes immediately after the procedure. Visual acuity was lightperception, however ophthalmologic examinations were unremarkable and the opticdiscs were pink with no swelling. Visual fields were severely affected, but neuroimagingwas normal. Within three months, visual acuity and visual fields improveddramatically but the optic discs became slightly pale.Conclusion: This is the first report of PION following PCNL. PION is a rare cause ofsevere visual loss following surgery. Severe blood loss, hypotension, anemia and bodyposition during surgery are the most important risk factors. Ophthalmologists,urologists and anesthesiologists should be aware of this condition and this rarepossibility should be considered prior to surgery.