Bony Orbital Decompression Following Lateral Canthotomy and Cantholysis for Traumatic Orbital Compartment Syndrome. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Kitaguchi, Yoshiyuki; Takahashi, Yasuhiro; Sabundayo, Maria Suzanne; Kakizaki, Hirohiko
• Is Part Of: Journal of craniofacial surgery. Volume 30:Issue 1(2019)
• Publication Date: 2019-01
• Subjects: Bony orbital decompression -- lateral canthotomy and cantholysis -- pupillary light reflex -- traumatic orbital compartment syndrome -- visual acuity; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000004902
• Languages: English
• ISSNs: 1049-2275

Abstract

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.