The frequency of perioperative vision loss

The frequency of perioperative vision loss, especially for spinal surgery, has been increasing recently. We undertook a retrospective study to determi ne the frequency of this outcome in a large surgical population receiving g eneral or central neuraxis regional anesthesia for noncardiac procedures fr om 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 data base screening found 405 cases of new-onset vision loss or visual changes i n 410,189 patients who underwent 501,342 anesthetics and who survived at le ast 30 days after their final procedures. Two hundred sixteen of these pati ents regained full vision or acuity within 30 days. Of the 189 patients who developed vision deficits for longer than 30 days, 185 underwent ophthalmo logic or neurologic procedures in which ocular or cerebral tissues were sur gically damaged or resected. The remaining 4 patients (1 per 125,234 overal l; 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.