Arat Yonca Ozkan, Dorotheo E Ulysses, Tang Rosa A, Boniuk Milton, Schiffman Jade S
Baylor College of Medicine, Houston, Texas, USA.
Ophthalmology. 2006 Feb;113(2):333-7. doi: 10.1016/j.ophtha.2005.11.003. Epub 2006 Jan 10.
We report 2 cases of compressive optic neuropathy after use of oxidized regenerated cellulose (ORC) in orbital surgery. To our knowledge, no complications have been reported previously after use of this material in orbital surgery. We also review the complications related to its retention at operative sites outside the orbit and recommend precautions to avoid them.
Retrospective interventional case reports.
Two patients with compressive optic neuropathy after use of ORC in orbital surgery.
Case reports from 2 different clinics and review of the English scientific literature.
Best-corrected visual acuity, extraocular motility, proptosis, and chemosis.
One patient underwent orbital exploration and biopsy of an orbital tumor, and the second had repair of an orbital floor fracture. Postoperatively, both presented with chemosis, ophthalmoplegia, and progressive loss of vision. Orbital imaging revealed a retrobulbar soft-tissue density compatible with hematoma. Repeat orbital exploration revealed the soft-tissue mass to be swollen ORC.
Retained intraorbital ORC may cause a compartment syndrome and should be suspected in postoperative patients with orbital symptoms. When ORC is used around the optic nerve, it should be removed after hemostasis is achieved.
我们报告2例在眼眶手术中使用氧化再生纤维素（ORC）后发生的压迫性视神经病变。据我们所知，此前在眼眶手术中使用这种材料后尚未有并发症的报道。我们还回顾了与ORC在眶外手术部位残留相关的并发症，并推荐预防措施以避免这些并发症。
回顾性干预病例报告。
2例在眼眶手术中使用ORC后发生压迫性视神经病变的患者。
来自2个不同诊所的病例报告及对英文科学文献的回顾。
最佳矫正视力、眼球运动、眼球突出和球结膜水肿。
1例患者接受了眼眶肿物探查及活检，另1例进行了眶底骨折修复。术后，2例患者均出现球结膜水肿、眼肌麻痹和视力进行性下降。眼眶影像学检查显示球后软组织密度影，与血肿相符。再次眼眶探查发现软组织肿块为肿胀的ORC。
眼眶内残留的ORC可能导致间隔综合征，术后出现眼眶症状的患者应怀疑有此情况。当在视神经周围使用ORC时，止血后应将其取出。
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