This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (29) Citing Articles via Google Scholar Google Scholar Articles by Warner, M. E. Articles by Warner, D. O. Search for Related Content PubMed PubMed Citation Articles by Warner, M. E. Articles by Warner, D. O. Related Collections Cardiovascular Heart Monitoring (Cardiac)

---

CARDIOVASCULAR ANESTHESIA

The Frequency of Perioperative Vision Loss

Mary E. Warner, MD^*, Mark A. Warner, MD^*, James A. Garrity, MD, Ronald A. MacKenzie, DO^*, and David O. Warner, MD^*

Departments of *Anesthesiology and Ophthalmology, Mayo Clinic, Rochester, Minnesota

Address correspondence and reprint request to Mary E. Warner, MD, Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905. Address e-mail to warner.mary{at}mayo.edu

The frequency of perioperative vision loss, especially for spinal surgery, has been increasing recently. We undertook a retrospective study to determine the frequency of this outcome in a large surgical population receiving general or central neuraxis regional anesthesia for noncardiac procedures from 1986 to 1998. Specific criteria were used to separate cases in which the surgical procedure likely directly contributed to the vision loss. Vision loss was present if any part of the visual field was affected. Initial database screening found 405 cases of new-onset vision loss or visual changes in 410,189 patients who underwent 501,342 anesthetics and who survived at least 30 days after their final procedures. Two hundred sixteen of these patients regained full vision or acuity within 30 days. Of the 189 patients who developed vision deficits for longer than 30 days, 185 underwent ophthalmologic or neurologic procedures in which ocular or cerebral tissues were surgically damaged or resected. The remaining 4 patients (1 per 125,234 overall; 0.0008%) developed prolonged vision loss without direct surgical trauma to optic or cerebral tissues. In this large study population of noncardiac surgical patients, including those who underwent spinal surgical procedures, the frequency of perioperative vision loss persisting for longer than 30 days was very small.

IMPLICATIONS: Vision loss and blindness after surgery and anesthesia is a very rare event. In this study, only one per 125,234 patients undergoing noncardiac surgery developed vision loss persisting for longer than 30 days.

This article has been cited by other articles:

				L. A. Lee and R. C. Morell Rare Complications and National Databases Anesth. Analg., November 1, 2009; 109(5): 1357 - 1359. [Full Text] [PDF]

				Y. Shen, M. Drum, and S. Roth 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 Anesth. Analg., November 1, 2009; 109(5): 1534 - 1545. [Abstract] [Full Text] [PDF]

				S. Yamashita, H. Takahashi, and M. Tanaka Bispectral index sensor as a possible cause of postoperative visual loss after frontal craniotomy Br. J. Anaesth., July 1, 2009; 103(1): 134 - 134. [Full Text] [PDF]

				J. W. Heitz and P. B. Audu Asymmetric postoperative visual loss after spine surgery in the lateral decubitus position Br. J. Anaesth., September 1, 2008; 101(3): 380 - 382. [Abstract] [Full Text] [PDF]

				H. Edgcombe, K. Carter, and S. Yarrow Anaesthesia in the prone position Br. J. Anaesth., February 1, 2008; 100(2): 165 - 183. [Abstract] [Full Text] [PDF]

				D. Kamming and S. Clarke Postoperative visual loss following prone spinal surgery Br. J. Anaesth., August 1, 2005; 95(2): 257 - 260. [Abstract] [Full Text] [PDF]

				M. S. Ozcan, C. Praetel, M. T. Bhatti, N. Gravenstein, M. E. Mahla, and C. N. Seubert The Effect of Body Inclination During Prone Positioning on Intraocular Pressure in Awake Volunteers: A Comparison of Two Operating Tables Anesth. Analg., October 1, 2004; 99(4): 1152 - 1158. [Abstract] [Full Text] [PDF]

				S. D. Kalyani, N. R. Miller, L. M. Dong, W. A. Baumgartner, D. E. Alejo, and T. B. Gilbert Incidence of and risk factors for perioperative optic neuropathy after cardiac surgery Ann. Thorac. Surg., July 1, 2004; 78(1): 34 - 37. [Abstract] [Full Text] [PDF]