Abstract: With advancements in surgical techniques and improvements in anesthesia protocols, the incidence of ophthalmic surgery-related complications has significantly decreased. Although the probability of severe cardiovascular complications remains extremely low, they can still occur. Therefore, ophthalmologists must have a comprehensive understanding of these complications to implement proactive preventive measures, promptly recognize symptoms, and administer optimal treatment, thereby maximizing patient prognosis. Among the complications triggered by ophthalmic surgery, cardiovascular events are the most prevalent. These include the oculocardiac reflex, which can lead to hemodynamic instability and cardiac arrest; iatrogenic venous air embolism (such as ocular venous air embolism or perfluorocarbon syndrome), which may cause pulmonary circulation disturbances, respiratory distress, and cardiogenic shock; and postoperative venous thromboembolism. This review aims to provide a systematic overview of severe cardiovascular complications related to ophthalmic surgery by synthesizing the latest evidence-based medical findings. It will focus on their pathogenesis, high-risk factors, typical symptoms and signs, and briefly discuss clinical management strategies, offering a reference for ophthalmic clinical practice.

Key words: Ophthalmic surgery, Complications, Cardiovascular events