[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.