Publications

Abstract
Introduction: Postoperative visual loss (POVL) after posterior approach to spine surgeries is a devastating complication
necessitating a prospective study. The primary aim was to identify ophthalmological changes contributing to POVL (visual
acuity, anterior segment, intraocular pressure (IOP), fundus, field of vision, external ocular examination). Secondary objectives
was to evaluate the relationship between ophthalmological changes and various perioperative data including patient
comorbidities, positioning and other intraoperative details.
Materials and Methods: After getting necessary approvals and consent, thirty patients posted for the posterior spine surgeries
were assessed preoperatively. Ophthalmological examination was conducted preoperatively, the day before surgery and
postoperatively twice (first within an hour of completion of surgery and second at twenty four hours). Perioperatively, data
including type of surgical frame, headrest used, duration of prone positioning, total blood loss, total intravenous fluids
administered, lowest mean arterial pressure for more than ten minutes, blood transfusion details and use of hypotensive
anaesthesia were noted. Data were analyzed using chi-square test, paired t test, and correlation coefficient.
Results: There were no changes in visual acuity, anterior segment, fundus and field of vision postoperatively. But 12 patients had
a rise in IOP and six developed lid edema and chemosis. There was a minimal increase in IOP at one hour post operatively (right
eye- 2.8 mm Hg (p=0.001, and left eye- 3 mmHg(p<0.001). The analysis of perioperative data revealed no relationship with
ophthalmological changes noted.
Conclusion: There were no clinically significant ophthalmological changes contributing to POVL in spine surgeries in prone
position. Observed ophthalmological changes did not have any correlation with patient comorbidities, positioning and other
intraoperative details.
Keywords: Intraocular pressure, Chemosis, Postoperative visual loss, posterior spine surgery, Prone position.