• Ehab Farag, Alaa A Abd-Elsayed, Jarrod E Dalton, Eman Nada, and Brian M Parker.
• Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH ; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH.
• Ochsner J. 2014 Jan 1; 14 (2): 179-83.

BackgroundPostoperative vision loss (POVL) after spine surgery is a rare but devastating outcome. We present the first case-control study from a single institution for POVL with the diagnoses of ischemic optic neuropathy or central vision loss after complex spine surgery.MethodsPOVL cases following spine surgeries between December 1995 and December 2010 at the Cleveland Clinic were identified retrospectively using administrative codes. Each instance of POVL was matched to 5 case-control patients based on age, gender, body mass index, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and hematocrit. Duration of anesthesia, fluid volumes, and hemodynamic measurements were then compared between POVL cases and control cases using Wilcoxon rank sum test.ResultsSix patients developed POVL. These patients had significantly greater blood loss (P=0.002, Wilcoxon test) and a significantly greater volume of red blood cells transfused (P=0.006) than the control patients. No other intraoperative measures differed significantly after Bonferroni correction for multiple outcomes.ConclusionWe found that patients with POVL had significantly greater blood loss and significantly more red blood cell transfusions than their matched controls.

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