Perioperative Vision Loss and Spine Surgery:
2019 Update on this issue of concern in surgery of the spine in the prone position. Risk factors include hypertension, diabetes, peripheral vascular disease, coronary artery disease, previous stroke, carotid artery stenosis), obesity, and tobacco use, as well as male sex. It is advised to inform patients in whom prolonged procedures, substantial blood loss, or both are anticipated that there may be an increased risk of perioperative visual loss.
Advice is offered to maintain blood pressure, and higher in those with hypertension. Deliberate hypotension should be avoided unless deemed absolutely essential. Head position should be at or above head level. Crystalloid or colloid alone or in combination can be used and blood products given based on hematocrit.