Post-Operative Vision Loss (POVL) following Surgical Procedures
School of Nurse Anesthesia, Texas Christian University, Fort Worth, USA
- *Corresponding Author:
- Heather Kendrick
School of Nurse Anesthesia
Texas Christian University
Fort Worth, TX 76129
E-mail: [email protected]
Received date: November 20, 2011; Accepted date: January 10, 2012; Published date: January 22, 2012
Citation: Kendrick H (2012) Post-Operative Vision Loss (POVL) following Surgical Procedures. J Anesthe Clinic Res 3:184. doi: 10.4172/2155- 6148.1000184
Copyright: © 2012 Kendrick H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Backgound: Postoperative vision loss (POVL), with a prevalence of 0.1% of cardiopulmonary bypass cases and 0.02% - 0.2% of spine surgery cases, is a rare but devastating complication that can occur in patients undergoing surgery in the prone position. Although the primary cause of this complication is unknown, POVL has been associated with anemia, hypotension (induced or due to hemorrhage), duration of surgery and over hydration. This author reviews the available evidence on the guidelines and management of these patients. Methods: A database search of MEDLINE, Academic Search Complete, Google Scholar, the Cochrane library, PubMed Central, and Embase was done using the key terms and phrases; postoperative vision loss, vision, ischemic optic neuropathy, prone position, perfusion, intraocular pressure, surgery, spinal surgery, scoliosis, blood flow and visual evoked potentials. Non-English language articles were excluded. The majority of the evidence retrieved included case studies, retrospective cohort studies and other literature reviews from dates ranging from 1995-2011. Results: There are no definitive guidelines for the management of patients undergoing spine surgery in the prone position. Conclusion: A synthesis of the literature revealed there is an increased risk of POVL in the presence of both preoperative and intraoperative risk factors. A medical history of diabetes, smoking and vascular disease can all contribute to the development of POVL. Intraoperative risk factors include, but are not limited to, pressure on the orbit, anemia, length of surgery, patient position and amount of volume infused.