INTRAOCULAR PRESSURE DURING LUMBAR DISC SURGERY - A COMPARATIVE STUDY BETWEEN PRONE POSITION AND KNEE-ELBOW POSITION
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Post-operative visual loss occurs more commonly in spinal surgery. Increased intra-ocular pressure is often implicated in the etiology of postoperative visual impairment. We investigated intraocular pressure in 20 patients undergoing lumber disc surgery. We classTied the patients into two groups: Group I: patients were in the knee-elbow position with the head resting on a cushion and turned to one side and group 11: patients were in prone position and the head neutral. We classified patients in knee-elbow position into two sub-groups; subgroup A where we measured 10P in nondependant eye and subgroup B where we measured IOP in dependant eye. In both groups we measured IOP during 2 times, the first time in both group when the patients were awake and in supine position and the second time was in group I at the end of surgery when the patients were still anesthetized and in knee elbow position and in group 11 at the end of surgery when the patients were still anesthetized and in prone position. In group I after mean duration of surgery 120+18 min. (mean ± SD), the mean intra-ocular pressure in the non-dependant eye was unchanged when compared to awake state 16.3+2.1 vs. 17.2+3.2 mmHg (p>0.05), whereas the intraocular pressure in the dependant eye had significantly increased 17.1+2.2 vs. 19.2+1.1 mmHg (p 0.05). In group H after mean duration of surgery 119+19 mmHg, mean intra-ocular pressure had highly significant increase compared to awake state 16.7+2.2 vs. 21.3+2.1 mmHg (p 0.01).