OPHTHALMIC COMPLICATIONS AFTER SPINAL SURGERY

Study Design, A retrospective review of 3450 spinal surgeries was perf ormed. Objectives. To review ophthalmic complications and their etiolo gies, as well as treatments and outcomes, in patients who have undergo ne spinal surgery. Summary of Background Data. Ophthalmic complication s after major spinal reconstructive surgery are rare and have not been adequately addressed in the orthopedic literature. Methods. In a seri es of 3450 spinal surgeries at three institutions, the authors identif ied seven patients (incidence = 0.20%) whose postoperative course was complicated by loss of visual acuity. These perioperative ophthalmic c omplications included posterior optic nerve ischemia, occipital robe i nfarcts, and central retinal vein thrombosis. Operative time, estimate d blood loss, and medical history of peripheral vascular, cardiovascul ar, or ophthalmic disease were obtained from the charts, as were follo w-up data. Results. Three patients recovered completely, and one had p artial return of visual function. in the remaining three patients, sig nificant visual loss persisted. Conclusions. The risk of ophthalmic co mplications with spinal surgery has not been fully appreciated. Becaus e ophthalmic complications in spinal surgery may be reversed with prom pt recognition and intervention, it is important for clinicians to be aware of their possible occurrence.