Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Neurosurg Focus. 2012 Aug;33(2):E14. doi: 10.3171/2009.8.FOCUS09151.
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.
术后俯卧位脊柱手术导致的视力丧失（POVL）是一种罕见但具有毁灭性的术后并发症。术后视力丧失的发生率和机制难以确定。公认的 POVL 有 4 种原因，分别是缺血性视神经病变（约 89%）、视网膜中央动脉阻塞（约 11%）、皮质梗死和眼外损伤。针对“俯卧位”手术的围手术期实践，目前仅有非常有限的指南或方案。但是，已经设计了一些新的设备来防止俯卧位脊柱手术中眼部受到机械性压迫。作者使用 PubMed 对俯卧位脊柱手术中使用的设备进行了文献检索。共发现 7 种设备；作者探讨了这些设备的特点、优点和缺点。POVL 的原因似乎是一个多因素的问题，其病理生理机制尚不清楚。因此，眼压迫是一个关键因素，使用这些设备消除任何对眼睛的明显压迫，可能有助于预防这种毁灭性的围手术期并发症。
