[Oculocardiac reflex in senile cataract operation].

OBJECTIVE

To determine the incidence of the oculocardiac reflex and to identify which steps in the process in senile cataract operation are more important in eliciting the reflex.

METHODS

Dynamic electrocardiogram was recorded with a 24 hour Holter's monitoring at the time of following steps: preoperation, retrobulbar anesthesia, softening of eyeball, superior rectus suture, corneoscleral incision, delivery of the nucleus and posterior chamber lens implantation. Oculocardiac reflex was defined as at least a 10% decrease in heart rate below relative baseline.

RESULTS

14 times of oculocardiac reflex occurred in 10 of 30 patients (33.3%). All maneuvers except for superior rectus fixation triggered the reflex in our group. In addition, premature beat was noted in 5 patients.

CONCLUSION

Our patients indicate that cataract extraction may result in abnormalities in both heart rate and rhythm. The definition of the oculocardiac reflex may be too conservative and requires redefinition.