Head Elevation by Ten Degrees in Prone Position Surgery Consistently Decreases and Minimizes Variation in Intraocular Pressure (IOP)

Purpose:The aim of this study is to explore the effect of10 Degree head elevation in prone position procedures on Intra-ocular pressure (IOP). Methods:A prospective, randomized observational study in 52 patients undergoing lumbar spine surgery in a tertiary care academic center, West Virginia University Hospital Patients (n = 52) between the ages of 18 and 80 undergoing lumbar spine fusion procedures in the prone position under standardized general anesthetics.Exclusion criteria were a diagnosis of tumor, infection, traumatic injury, a history of eye disease, ocular surgery, cervical spine surgery, chronic neck pain, or cervical stenosis.Patients were randomized into one of two treatment groups for surgery: Group 1: Head neutral prone position Group 2: 10 Degree head elevation in prone position Results: IOP was measured at specific, defined intervals including: prior to induction, supine after induction, after prone positioning and at defined intervals throughout the procedure, and after supine positioning at conclusion of the surgery.Corresponding blood pressure and pCO 2 measurements were recorded at each time point. Conclusions:• The 10-degree head elevation position significantly decreased the rate of increase of IOP in as early as 30 minutes in the prone position.• A lower degree of variation and increased consistency in IOP was found in patients in the 10-degree head elevation group compared to the control group.