ANTERIOR ISCHEMIC OPTIC NEUROPATHY FOLLOWING NECK DISSECTION

Background: Ischemic optic neuropathy (ION) is a rare but devastating complication of surgery. It has traditionally been associated with int raoperative hypotension in patients with underlying arteriosclerosis. Methods: We present a case of ION following bilateral neck dissections in which there was minimal intraoperative hypotension and preservatio n of both internal jugular veins. The potential etiology of this disea se is discussed along with a review of the literature. Results: Five c ases of ION following neck dissection have been documented. This compl ication is associated with the combination of intraoperative hypotensi on and anemia in the setting of prolonged bilateral neck dissection. T reatment is supportive, and final visual prognosis is variable. Conclu sions: Ischemic optic neuropathy following neck dissection is best avo ided by intraoperative blood pressure and anemia management. When it d oes occur, supportive therapy must be given. Final visual outcome is v ariable. (C) 1997 John Wiley & Sons, Inc.