Prevention of Ocular Complications in Spine Surgery Patients in the Prone Position

¹ The First Clinical Medical College of China, Three Gorges University & Department of Spine Surgery, Central People’s Hospital of Yichang City, Yichang, Hubei, China.,

² School of Nursing, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China;Key Laboratory of Geriatric Nursing and Health, Anhui University of Chinese Medicine,

BAS 2025 , 3(4), 90–93; https://doi.org/10.26689/bas.v3i4.11732

© 2025 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

Objective: To investigate the causes and preventive methods for blindness after spine surgery in the prone position. Methods: A retrospective analysis was conducted on the data of three patients who developed blindness after prone-position spinal surgery. Results: One patient died. Two patients were followed up 5 to 6 months after discharge, with no recovery of vision. Both patients remained blind in both eyes. Conclusion: Postoperative blindness in patients undergoing prone-position spine surgery is rare and difficult to treat once it occurs. Early recognition and prevention are essential to avoid this catastrophic complication.

References

Slocum H, O’Neal K, Allen C, 1948, Neurovascular Complications from Malposition on the Operating Table. Surg Gynecol Obstet, 86(6): 729–734.

Shen Y, Drum M, Roth S, 2009, 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, 109(5): 1534–1545.

Shi J, Wang Z, Zhao H, et al., 2006, Report of 4 Cases of Blindness After Prone Position Spine Surgery. Ningxia Medical Journal, 28(4): 2.

Li Z, Zeng J, 2014, Research Progress on Blindness in Patients After Prone Position Spine Surgery. Chinese Journal of Spine and Spinal Cord, 24(2): 4.

Kathleen T, Berg T, et al., 2010, Perioperative Visual Loss in Ocular and Nonocular Surgery. Clinical Ophthalmology, 4: 531–546.

Sun H, Zhang J, Zhang Z, et al., 1999, Report of 5 Cases of Short-Term Blindness Due to Hemorrhagic Shock. Chinese Journal of Emergency Medicine, 19(5).

Lee L, Roth S, Posner K, et al., 2006, The American Society of Anesthesiologists Postoperative Visual Loss Registry: Analysis of 93 Spine Surgery Cases with Postoperative Visual Loss. Anesthesiology, 105(4): 652–659.

Li M, Ling Y, Liu X, et al., 2001, The Effect of Central Retinal Artery Occlusion Ischemia on the Retinal Ganglion Cells in the Macula. Chinese Journal of Pathophysiology, 17(8): 3.

Hayreh S, Jonas J, 2000, Optic Disk and Retinal Nerve Fiber Layer Damage After Transient Central Retinal Artery Occlusion: An Experimental Study in Rhesus Monkeys. American Journal of Ophthalmology, 129(6): 786–795.

Luo L, Zhou P, 2016, Observation on the Effect of Standardized Management in Preventing Postoperative Blindness After Prone Position Spine Surgery. Chinese Journal of Clinical Physicians: Electronic Edition, 10(7): 2.

American Society of Anesthesiologists Task Force on Perioperative Visual Loss, 2012, Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery: An Updated Report. Anesthesiology, 116(2): 274.

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