50. POSTOPERATIVE VISUAL LOSS IN THE PRONE POSITION SPINE SURGERY: A CASE REPORT

Trinh Tan Thin1, Le Van Chung1
1 Saigon ITO Hospital System

Main Article Content

Abstract

Background: Postoperative visual loss in the prone position spine surgery is very rare, but this complication can result in severe consequences. Common causes include ischemic optic neuropathy, central retinal artery occlusion, and cortical blindness. Risk factors include peripheral vascular disease, hypertension, anemia, and diabetes mellitus with end-organ damage.


Objective: Identify the causes and prevention of postoperative visual loss in the prone position spine surgery due to acute angle-closure Glaucoma.


Materials and methods: A case report, describes a 62-year-old female patient who was scheduled for decompression and spinal fusion surgery at the L4-S1 levels due to lumbar disc herniation and spinal canal stenosis at L4/L5 and L5/S1.


Results: After surgery, the patient complained of eye pain, blurred vision, and redness in both eyes, along with generalized edema. Ophthalmologic examination revealed acute angle closure in both eyes, with a provisional diagnosis of angle-closure Glaucoma. The treatment plan included initial medical management, followed by eye surgery once spinal postoperative recovery was stabilized.


Conclusion: Postoperative visual loss in the prone position spine surgery is a rare but serious complication, for which the most effective treatment remains prevention.

Article Details

References

[1] Yang Shen, Melinda Drum, Steven Roth. The prevalence of perioperative visual loss in the United States: A 10-year study from 1996 to 2005 of spinal, orthopedic, cardiac, and general surgery. Anesthesia & Analgesia, 2009, 109 (5), pp. 1534-1545.
[2] Andrew J Brunk, Ken P Ehrhardt, Jeremy B Green, Susie M Mothersele, Alan David Kaye. Postoperative Visual Loss: Anatomy, pathogenesis, and anesthesia considerations. Springer International Publishing, 2019, pp. 19-29.
[3] Nandyala R.V, Alejandro Marquez-Lara, Steven J Fineberg, Richa Singh, Kern Singh. Incidence and risk factors for perioperative visual loss after spinal fusion. Spine, 2014, pp. 1-6.
[4] Andrés E Cobar-Bustamante, Mario A Cahueque, Gustavo Caldera. Case report visual loss after spine surgery: Case report. Journal of Orthopaedics, 2016, 13 pp. 239-241.
[5] Jeffrey L Apfelbaum, Richard T Connis, Madhulika Agarkar. Practice advisory for perioperative visual loss associated with spine surgery 2019, an updated report by the American Society of Anesthesiologists Task Force on Perioperative Visual Loss, the North American Neuro Ophthalmology Society, and the Society for Neuroscience in anesthesiology and critical care. Anesthesiology, 2019, 130, pp. 12-30.
[6] Michael S Singer, Sarwat Salim. Case Report: Bilateral acute angle-closure Glaucoma as a complication of facedown spine surgery. The Spine Journal, 2010, 10, pp. 7-9.