TY - JOUR
T1 - Perioperative Vision Loss in Spine Surgery and Other Orthopaedic Procedures
AU - Su, Alvin W.
AU - Lin, Shuai Chun
AU - Larson, A. Noelle
N1 - Publisher Copyright:
© Copyright 2016 by the American Academy of Orthopaedic Surgeons.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Perioperative vision loss is a rare complication of orthopaedic surgery and has been documented after spine, knee, hip, and shoulder procedures. It is associated with several ophthalmologic diagnoses, most commonly ischemic optic neuropathy. Although the pathophysiology remains unclear, current evidence suggests that systemic hemodynamic compromise and altered balance of intraocular perfusion contribute to the development of ischemic optic neuropathy. Although vision recovery has been reported, the prognosis of perioperative vision loss is poor, and no proven effective treatment is available. Perioperative vision loss is unpredictable and can occur in healthy patients. Associated risk factors include pediatric or elderly age, male sex, obesity, anemia, hypotension or hypertension, perioperative blood loss, prolonged surgical time, and prone positioning. Preventive strategies include avoiding direct pressure to the eye, elevating the head, optimizing perioperative hemodynamic status, and minimizing surgical time with staged surgical procedures as appropriate.
AB - Perioperative vision loss is a rare complication of orthopaedic surgery and has been documented after spine, knee, hip, and shoulder procedures. It is associated with several ophthalmologic diagnoses, most commonly ischemic optic neuropathy. Although the pathophysiology remains unclear, current evidence suggests that systemic hemodynamic compromise and altered balance of intraocular perfusion contribute to the development of ischemic optic neuropathy. Although vision recovery has been reported, the prognosis of perioperative vision loss is poor, and no proven effective treatment is available. Perioperative vision loss is unpredictable and can occur in healthy patients. Associated risk factors include pediatric or elderly age, male sex, obesity, anemia, hypotension or hypertension, perioperative blood loss, prolonged surgical time, and prone positioning. Preventive strategies include avoiding direct pressure to the eye, elevating the head, optimizing perioperative hemodynamic status, and minimizing surgical time with staged surgical procedures as appropriate.
KW - central retinal artery occlusion
KW - cerebral blindness
KW - ischemic optic neuropathy
KW - perioperative complication
KW - prone position
KW - retinal ischemia
KW - spine
KW - vision loss
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U2 - 10.5435/JAAOS-D-15-00351
DO - 10.5435/JAAOS-D-15-00351
M3 - Review article
C2 - 27564793
AN - SCOPUS:84988815615
SN - 1067-151X
VL - 24
SP - 702
EP - 710
JO - Journal of the American Academy of Orthopaedic Surgeons
JF - Journal of the American Academy of Orthopaedic Surgeons
IS - 10
ER -