Transient blindness associated with transurethral resection of the prostate
D. J. Creel, J. M. Wang and K. C. Wong
Veterans Administration Medical Center, Salt Lake City, UT 84148.
Visual impairment or even transient blindness can result from transurethral
resection of the prostate when glycine is used as the irrigating fluid.
Electroretinograms were obtained from patients in the anesthetic
preparation area and in the recovery room immediately after surgery. Four
patients reported visual aberrations ranging from a "gray darkening" to
"light perception only" coincident with elevated serum levels of glycine.
Electroretinograms consistently demonstrated a loss of oscillatory
potentials only in those patients with visual impairment. Thirty-hertz
"flicker-following" was also attenuated. The excessive serum levels of
glycine may contribute to visual impairment and may account for the dropout
of oscillatory potentials generated by the retina due to glycine's role in
the retina as an inhibitory transmitter.
