Kitaguchi Yoshiyuki, Takahashi Yasuhiro, Sabundayo Maria Suzanne, Kakizaki Hirohiko
Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan.
J Craniofac Surg. 2019 Jan;30(1):231-234. doi: 10.1097/SCS.0000000000004902.
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.
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.
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.
Bony orbital decompression is effective for the treatment of traumatic orbital compartment syndrome in patients whose preoperative visual acuity is counting fingers or better.
描述因外眦切开及眦松解术后瞳孔对光反射持续异常而接受眼眶骨性减压的创伤性眼眶间隔综合征患者的临床病程。
回顾性分析连续4例患者。由于瞳孔对光反射无改善且即使在外眦切开及眦松解术后眼眶仍紧绷，作者进行了眼眶骨性减压。
受伤至骨性减压的中位间隔时间为8.8小时（范围7 - 12小时）。所有患者术前眼压均为40 mmHg或更高，次日降至20 mmHg或更低。2例患者出现眼球帐篷样改变，眼球后角为110°或更小，次日得到缓解。2例初始视力为眼前指数或更好的患者视力完全恢复。相比之下，2例无光感患者中只有1例术后稍有改善至光感，另1例术后无改善。
眼眶骨性减压对于术前视力为眼前指数或更好的创伤性眼眶间隔综合征患者的治疗有效。
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