Asymmetric postoperative visual loss after spine surgery in the lateral decubitus position

Heitz, James W.; Audu, Paul

doi:10.1093/bja/aen163

Cited by 27 publications

(13 citation statements)

References 12 publications

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“…One case report describes a 59-year-old woman who suffered complete visual loss in the dependent eye after spine surgery in the LDP [9]. In addition, two cases of POVL in which spine surgery was performed in the LDP are included in the American Society of Anesthesiologists (ASA) POVL Registry [10].…”

Section: Introductionmentioning

confidence: 99%

Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia

Yamada

Takazawa

Iriuchijima³

et al. 2015

J Clin Monit Comput

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Intraocular pressure (IOP) has been shown to change with body position. Several studies have shown that the lateral decubitus position (LDP) is associated with a significant increase in IOP in the dependent eye. However, whether anesthetic agents alter IOP in the LDP remains unclear. This study investigated the effect of sevoflurane and propofol anesthesia on IOP in the LDP. A total of 28 patients undergoing surgery in the LDP were included. Patients were randomly allocated to sevoflurane or propofol groups. IOP in both eyes was recorded and compared between groups at five time points: after anesthesia induction, after endotracheal intubation, at 5 min and 1 h after a positional change to the LDP, and 5 min after returning to the supine position. In the sevoflurane group, IOP was significantly increased in both dependent and non-dependent eyes 1 h after changing to the LDP. In the propofol group, IOP decreased in both dependent and non-dependent eyes after tracheal intubation, but did not increase after changing to the LDP. The number of patients in whom IOP increased to ≥28 mmHg was greater in the sevoflurane group than in the propofol group. Propofol may be better than sevoflurane for the maintenance of anesthesia in the LDP. Monitoring of IOP in the LDP might help avoid ophthalmic complications.

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Section: Introductionmentioning

confidence: 99%

Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia

Yamada

Takazawa

Iriuchijima³

et al. 2015

J Clin Monit Comput

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“…This is a unique case, in that most other reports on POVL show patients who do not improve after suffering this devastating complication [1,4,[11][12][13]. Our patient had transient POVL, which resolved completely within 48 h. ION occurs after an ischemic insult to the optic nerve and can be divided into anterior ischemic optic neuropathy (AION) and PION depending on the location of the lesion [14].…”

Section: Discussionmentioning

confidence: 72%

“…It is likely that a combination of modest increments in length of surgery in the prone position (8 h), blood loss (1,500 cc) and fluid overload (5,700 cc) may have all contributed to a reduction in perfusion pressure (the difference between mean arterial pressure and intraocular pressure) to the optic nerve intraoperatively and resulted in the POV [12]. However, the CSF leak during the incidental durotomy should have had a 'protective' effect on this-it has been suggested that intracranial pressure is decreased in patients with ocular hypotension and vice versa [17].…”

Section: Discussionmentioning

confidence: 99%

Transient bilateral post-operative visual loss in spinal surgery

2011

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Background Post-operative visual loss (POVL) following spinal surgery is a rare but devastating complication. Although a number of intra-operative and post-operative factors have been implicated, the exact etiology may still remain unclear. Purpose To report a unique case of transient bilateral POVL in a patient who had undergone lumbar surgery in the prone position. Study design/setting This patient was followed up prospectively for 1 year. Methods Prospective follow-up of a single patient following spinal surgery, who developed transient bilateral POVL. Results This patient's visual loss improved within 48 h. Conclusion This is the only documented case of POVL to have resolved completely within 48 h.

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“…Based on a report from the American Anesthesiologist Society, postoperative visual loss was found in 83 patients of the 93 reported, and had strong correlation to spine surgery. Multiple risk factors were described [5][6][7][8][9][10] (Table 3).…”

Section: Discussionmentioning

confidence: 99%

Visual loss after spine surgery: Case report

Cobar-Bustamante

Cahueque

Hernández

2016

Journal of Orthopaedics

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The presence of postoperative visual loss is a well-known complication, and described in various reports, its low incidence (0.028-0.2%) makes it extremely rare. Two main causes have been determined: Posterior Ischemic Optic Neuropathy and central Retinal Artery Oclusion. The following is a case report of a 52-year-old patient that presented visual loss after elective spine surgery that had no complications that could initially explain this complication. Studies were performed and evaluations by ophthalmologists determined that the cause of Posterior Ischemic Optic Neuropathy due to multiple risk factors that the patient had previously and during the surgery. After 3 year follow-up the patient still has total visual loss and no other complications were reported.

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Asymmetric postoperative visual loss after spine surgery in the lateral decubitus position

Cited by 27 publications

References 12 publications

Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia

Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia

Transient bilateral post-operative visual loss in spinal surgery

Visual loss after spine surgery: Case report

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