Vision loss after spine surgery: a new hypothesis.

摘要

As new reports concerning vision loss after spine surgery continue to be published, it is crucial to explore possible mechanisms. The incidence of vision loss after noncardiac surgery is 0.0008%, while it is 0.2% following spine surgery, with the causes usually taken to be anemia or hypotension. We hypothesize a possible additional mechanism: that the use of large amounts of crystalloids in such cases can lead to an accumulation of edema in the eye socket with the production of an "eye compartment syndrome". Presumably, increased eye socket pressure in this setting can lead to ischemia of the optic nerve, especially in the posterior segment having a single blood supply derived from the ophthalmic artery.