[Changes in retinal nerve fiber layer thickness after spinal surgery in the prone position: a prospective study]

Area of Science:

• Ophthalmology
• Neurosurgery
• Anesthesiology

Context:

• Ocular perfusion pressure (mean arterial pressure minus intraocular pressure) is critical for preventing ischemic optic neuropathy.
• Spinal surgery, particularly in the prone position, can alter hemodynamic parameters.
• Understanding these changes is vital for patient eye health during and after surgery.

Purpose:

• To investigate the impact of spinal surgery in the prone position on intraocular pressure (IOP) and retinal nerve fiber layer (RNFL) thickness.
• To correlate changes in IOP and ocular perfusion pressure with RNFL thickness postoperatively.

Summary:

• This prospective study monitored 30 patients undergoing spinal surgery.
• Intraocular pressure and RNFL thickness were measured before and after surgery.
• Results indicated a significant increase in IOP and decrease in ocular perfusion pressure during prone positioning, alongside significant RNFL thinning in inferior and nasal quadrants post-surgery.

Impact:

• Findings highlight a potential risk of RNFL damage during prone spinal surgery.
• Suggests the need for monitoring intraocular pressure and ocular perfusion during such procedures.
• Informs strategies to mitigate optic neuropathy risk in patients undergoing spinal surgery.