Blandford Alexander D, Young Jason M, Arepalli Sruthi, Li Ang, Hwang Catherine J, Perry Julian D
Cole Eye Institute, Cleveland Clinic, Cleveland.
Department of Internal Medicine, Riverside Methodist Hospital, Columbus, Ohio, U.S.A.
Ophthalmic Plast Reconstr Surg. 2018 Sep/Oct;34(5):428-431. doi: 10.1097/IOP.0000000000001032.
The authors assess the effectiveness of a modified paracanthal or "one-snip" procedure compared with the traditional lateral canthotomy and inferior cantholysis in the reduction of intraocular pressure (IOP) and proptosis in a human cadaveric model of retrobulbar hemorrhage.
This study comprised a comparative interventional study in a cadaveric model of retrobulbar hemorrhage. Six orbits of 3 fresh cadavers were included in the study. Baseline measurements of IOP and proptosis were recorded for all 6 orbits before and after simulation of retrobulbar hemorrhage as previously described. Right orbits (n = 3) underwent traditional lateral canthotomy and inferior cantholysis. Left orbits (n = 3) underwent modified paracanthal or "one-snip" procedure. The primary outcome measures were reduction in IOP and proptosis between the 2 techniques.
Following lateral canthotomy and inferior cantholysis of each right orbit, the average IOP dropped to 14 mm Hg (range of 11-18 mm Hg), corresponding to a mean decrease of 32 mm Hg. Following the "one-snip" procedure of each left orbit, the average IOP dropped to 19 mm Hg with a range of 16 to 23 mm Hg, corresponding to a mean decrease of 22 mm Hg. There was no statistically significant difference in IOP reduction (p = 0.36) or proptosis reduction (p = 0.23) between the 2 treatment groups.
Compared with traditional lateral canthotomy xand inferior cantholysis, the modified paracanthal or "one-snip" procedure is effective for IOP reduction and led to mild improvement of proptosis in a cadaveric model of retrobulbar hemorrhage. The authors hope this study helps improve orbital compartment syndrome outcomes by providing an option that more providers will feel comfortable performing and therefore decreasing time to surgical decompression.
作者评估改良的睑裂旁切开术或“单剪”手术与传统的外眦切开术及下睑眦部松解术相比，在球后出血的人体尸体模型中降低眼压（IOP）和眼球突出度的效果。
本研究为球后出血尸体模型的比较性干预研究。纳入3具新鲜尸体的6个眼眶。如前所述，在模拟球后出血前后，记录所有6个眼眶的眼压和眼球突出度的基线测量值。右眼眶（n = 3）接受传统的外眦切开术及下睑眦部松解术。左眼眶（n = 3）接受改良的睑裂旁切开术或“单剪”手术。主要观察指标为两种技术之间眼压和眼球突出度的降低情况。
对每个右眼眶进行外眦切开术及下睑眦部松解术后，平均眼压降至14 mmHg（范围为11 - 18 mmHg），平均降低32 mmHg。对每个左眼眶进行“单剪”手术后，平均眼压降至19 mmHg，范围为16至23 mmHg，平均降低22 mmHg。两个治疗组之间眼压降低（p = 0.36）或眼球突出度降低（p = 0.23）均无统计学显著差异。
与传统的外眦切开术及下睑眦部松解术相比，改良的睑裂旁切开术或“单剪”手术在球后出血的尸体模型中可有效降低眼压，并使眼球突出度有轻度改善。作者希望本研究通过提供一种更多医疗人员会更愿意实施的选择，从而减少手术减压时间，有助于改善眼眶间隔综合征的治疗效果。
