Saoulidou Eleftheria N, Giavi Varvara D, Paidakakos Nikolaos A, Papaconstantinou Dimitrios S, Dimakopoulou Antonia N, Matsota Paraskevi K
2nd Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC.
Anesthesiology, General Hospital of Athens "Georgios Gennimatas", Athens, GRC.
Cureus. 2025 May 6;17(5):e83617. doi: 10.7759/cureus.83617. eCollection 2025 May.
Postoperative vision loss is a rare complication following surgery in prone positioning. Waking with loss of visual acuity after an elective nonocular surgery is a catastrophic event, not only for the patient but also for the physicians. The specific pathogenesis of postoperative vision loss remains unknown in most cases. This systematic review aims to investigate the effect of prone positioning on intraocular pressure in patients undergoing surgeries and alert physicians to the potential vision loss in the postoperative period. A meticulous research of PubMed, Scopus, and Google Scholar databases was conducted for relevant articles published between January 2012 and September 2023. All relative prospective, retrospective, comparative, and non-comparative studies that investigated prone position and its effect on intraocular pressure during surgery were considered eligible for inclusion in our systematic review. A total of eight studies comprising 649 patients who underwent nonocular surgery under prone positioning were reviewed. Most patients underwent spine surgery with total intravenous anesthesia. The device most frequently used for intraocular pressure measurement was Tono-Pen® XL (Medtronic plc, Galway, Ireland). None of the patients suffered from visual loss postoperatively. Only three patients had vision disturbances after surgery due to prone positioning. There was also a significant rise in intraocular pressure from the supine to the prone position. There is a need to identify crucial factors for the prevention of postoperative vision loss.
术后视力丧失是俯卧位手术后一种罕见的并发症。在择期非眼科手术后醒来出现视力下降，这对患者和医生来说都是灾难性事件。在大多数情况下，术后视力丧失的具体发病机制尚不清楚。本系统评价旨在研究俯卧位对接受手术患者眼压的影响，并提醒医生注意术后潜在的视力丧失。对PubMed、Scopus和谷歌学术数据库进行了细致检索，查找2012年1月至2023年9月期间发表的相关文章。所有调查俯卧位及其对手术期间眼压影响的相对前瞻性、回顾性、比较性和非比较性研究均被认为符合纳入我们系统评价的条件。共回顾了八项研究，包括649例在俯卧位下接受非眼科手术的患者。大多数患者接受脊柱手术，采用全静脉麻醉。最常用于眼压测量的设备是Tono-Pen® XL（美敦力公司，爱尔兰戈尔韦）。没有患者术后出现视力丧失。只有三名患者术后因俯卧位出现视力障碍。从仰卧位到俯卧位眼压也有显著升高。需要确定预防术后视力丧失的关键因素。
