Perioperative Vision Loss in Spine Surgery and Other Orthopaedic Procedures

Alvin W. Su, Shuai Chun Lin, A. Noelle Larson

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)702-710
Number of pages9
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume24
Issue number10
DOIs
StatePublished - Oct 1 2016

Keywords

  • central retinal artery occlusion
  • cerebral blindness
  • ischemic optic neuropathy
  • perioperative complication
  • prone position
  • retinal ischemia
  • spine
  • vision loss

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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