Increasing numbers of patients have suffered vision loss after general surgery over the last 15 years, according to an article published in this month's Journal of Neuro-Ophthalmology.
Two major retrospective studies have shown that postoperative vision loss (POVL) can be as high as 4.5 per cent after heart surgery and 0.2 per cent after spinal surgery.
'A variety of factors have been identified as contributing to the various causes of POVL. Some of these are intrinsic to the patient and may be thought of as predisposing factors, while others are related more directly to surgery and anaesthesia,' explained the article author, Dr Molly E Gilbert, from the University of Illinois Eye and Ear Infirmary. Factors include intraocular pressure rises related to the position of the patient during surgery and the use of large amounts of intravenous fluids as well as complications related to general anaesthesia.
Recommendations to reduce the incidences of POVL include: taking careful preoperative history to identify any pre-existing patient risk factors that predispose to POVL considered use of deliberate hypotension in patients at risk and avoidance of compression of the eyes, abdomen or chest in patients placed prone.