title: Current intraoperative devices to reduce visual loss after spine surgery.
abstract: Postoperative visual loss (POVL) after spine surgery performed with the patient prone is a rare but devastating postoperative complication. The incidence and the mechanisms of visual loss after surgery are difficult to determine. The 4 recognized causes of POVL are ischemic optic neuropathy (approximately 89%), central retinal artery occlusion (approximately 11%), cortical infarction, and external ocular injury. There are very limited guidelines or protocols on the perioperative practice for "prone-position" surgeries. However, new devices have been designed to prevent mechanical ocular compression during prone-position spine surgeries. The authors used PubMed to perform a literature search for devices used in prone-position spine surgeries. A total of 7 devices was found; the authors explored these devices' features, advantages, and disadvantages. The cause of POVL seems to be a multifactorial problem with unclear pathophysiological mechanisms. Therefore, ocular compression is a critical factor, and eliminating any obvious compression to the eye with these devices could possibly prevent this devastating perioperative complication.
authors.affiliation: Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Uribe
authors.forename: Mirza N
authors.initials: MN
authors.lastname: Baig
authors.forename: Erika G
authors.initials: EG
authors.lastname: Puente
authors.forename: Adolfo
authors.initials: A
authors.lastname: Viloria
authors.forename: Ehud
authors.initials: E
authors.lastname: Mendel
authors.forename: Sergio D
authors.initials: SD
authors.lastname: Bergese
mesh_terms: D006801:Humans; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery*; D013122:Spinal Diseases / Q000473:pathology / Q000601:surgery; D014786:Vision Disorders / Q000209:etiology / Q000517:prevention & control*