Bony Orbital Decompression Following Lateral Canthotomy and Cantholysis for Traumatic Orbital Compartment Syndrome.

Abstract

PURPOSE:

To describe the clinical course of patients with traumatic orbital compartment syndrome who underwent bony orbital decompression due to persistently abnormal pupillary light reflex after lateral canthotomy and cantholysis.

METHODS:

Four consecutive patients were retrospectively reviewed. The authors performed bony orbital decompression as there was no improvement in the pupillary light reflex and a tight orbit persisted even after lateral canthotomy and cantholysis.

RESULTS:

The median interval between injury and bony decompression was 8.8 hours (range, 7-12 hours). All patients showed a preoperative intraocular pressure of 40 mm Hg or greater, which decreased to 20 mm Hg or less the next day. Two patients showed globe tenting with a posterior globe angle of 110° or less, which was resolved on the following day. Two patients with initial visual acuity of counting fingers or better showed complete visual recovery. By contrast, only 1 of the 2 patients with no light perception slightly improved to light perception while the other showed no improvement after surgery.

CONCLUSIONS:

Bony orbital decompression is effective for the treatment of traumatic orbital compartment syndrome in patients whose preoperative visual acuity is counting fingers or better.

• Authors: Yoshiyuki Kitaguchi, Yasuhiro Takahashi, Maria Suzanne Sabundayo, Hirohiko Kakizaki
• Journal: The Journal of craniofacial surgery (J Craniofac Surg) Vol. 30 Issue 1 Pg. 231-234 (Jan 2019) ISSN: 1536-3732 [Electronic] United States
• PMID: 30444775 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Compartment Syndromes (diagnosis, surgery)
• Decompression, Surgical (methods)
• Eye Injuries (complications, diagnosis, surgery)
• Eyelids (surgery)
• Female
• Humans
• Male
• Middle Aged
• Neurosurgical Procedures (methods)
• Orbit (diagnostic imaging, injuries, surgery)
• Orbital Diseases (diagnosis, etiology, surgery)
• Retrospective Studies
• Tomography, X-Ray Computed
• Visual Acuity
• Young Adult