Surgical management of orbital lymphangioma with the carbon dioxide laser.

Lymphangiomas of the ocular adnexa, especially those in the orbit, are difficult to treat because the unencapsulated tumor freely interdigitates with normal orbital tissue, obliterating any potential surgical plane. Because of the hemorrhagic and friable nature of the tumor, conventional surgical techniques are frequently complicated by bleeding. We used the CO2 laser to remove these lesions subtotally by controlled vaporization in six patients (four girls and two boys, 5 to 17 years old). Three pupils remained dilated postoperatively because of damage to the ciliary nerves and symblepharon formation occurred in one case. None of these has produced any symptoms. In one case, however, laser treatment may have produced corneal anesthesia.