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Emerg Med J 2019 Jan 10. Epub 2019 Jan 10.

Emergency Department, Birmingham Children's Hospital, Birmingham, UK.

Introduction: Acute retrobulbar haemorrhage (RBH) with orbital compartment syndrome is a sight-threatening ophthalmic emergency requiring treatment with lateral canthotomy and cantholysis (LC/C). However, such cases may present to non-ophthalmic emergency departments (ED) out-of-hours, when specialist intervention is not readily available. We completed a survey of ED physicians to explore experiences of RBH and confidence in undertaking LC/C. Read More

Open Vet J 2018 22;8(4):445-451. Epub 2018 Nov 22.

Department of Clinical Sciences, Companion and Equine Animals, Ophthalmology, University of Liège, Quartier Vallée 2, Avenue de Cureghem 3, 4000 Liège, Belgium.

Orbital compartment syndrome (OCS) is described in humans as an acute rise in intraorbital pressure following a severe and rapidly evolving orbital affection. It includes orbital oedema, haemorrhage or infection causing a marked reduction in local blood perfusion, and severely affecting the orbital neurovascular structures. If not promptly recognised and treated, it results in irreversible blindness. Read More

J Craniofac Surg 2019 Jan;30(1):231-234

Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan.

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. Read More

Am J Emerg Med 2018 Nov 7. Epub 2018 Nov 7.

Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address:

A ruptured cavernous carotid aneurysm (CCA) with carotid cavernous fistula can appear as a benign headache but progress to a swollen and bloodshot eye overnight. A 66-year-old woman visited emergency department with sudden onset of pain behind her left forehead and vomiting. She was treated for a migraine-like headache and discharged. Read More

J Emerg Med 2018 Oct 30. Epub 2018 Oct 30.

New York University School of Medicine, New York, New York.

Background: The treatment of orbital compartment syndrome has a rich history rooted in surgery and emergency medicine. It is a rare but acute and vision-threatening condition that most commonly occurs secondary to facial trauma or as a postoperative complication, and was first recognized in 1950. Surgical techniques and medical management were developed and refined soon afterwards to eventually become the modern-day treatment, lateral canthotomy, and inferior cantholysis. Read More

J Craniomaxillofac Surg 2018 Oct 11;46(10):1726-1730. Epub 2018 Aug 11.

Department of Oral and Maxillofacial Surgery of the Hospital Clínico Mutual de Seguridad, Chile.

The purpose of the study was to analyze and describe the retrocaruncular approach to access medial orbital wall. A retrospective analysis was performed in patients referred for the treatment of orbital fractures between January 1st 2011 and July 31st 2017. The study included patients over 18 years old with isolated fractures of the medial orbital wall or combined with the orbital floor who underwent a transconjunctival approach with retrocaruncular extension and lateral canthotomy, and with a minimum follow-up of 6 months. Read More

Ophthalmic Plast Reconstr Surg 2019 Jan/Feb;35(1):1-6

Ophthalmic Plastic and Reconstructive Surgery Service, Department of Ophthalmology of the Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

Purpose: The objective of this study was to report a case of persistent and likely self-induced orbital emphysema (OE) following functional endoscopic sinus surgery with dislodgement of a previously placed orbital floor implant and to review the literature surrounding etiologies, pathophysiology, and management of OE.

Methods: Case report and review of the literature.

Results And Discussion: While blunt trauma resulting in disruption of the medial orbital wall is the most common cause of OE, there are an additional 25 underlying etiologies reported in the current literature. Read More

Arch Plast Surg 2018 Jul 15;45(4):325-332. Epub 2018 Jul 15.

Department of Anatomy, Chungnam National University College of Medicine, Daejeon, Korea.

Background: Zygomaticomaxillary complex (ZMC) fractures mostly occur in the form of tripod fractures. The surgical field is accessed using a combination of three classic approaches. However, the subciliary incision may have unfavorable aesthetic results. Read More

Ophthalmic Plast Reconstr Surg 2019 Jan/Feb;35(1):62-66

Retina Group of Washington DC, Greenbelt, Maryland, U.S.A.

Purpose: To describe outcomes and associated ocular injuries of lateral canthotomy and cantholysis (LCC) as performed in combat ocular trauma.

Methods: Data from the Walter Reed Ocular Trauma Database of patients requiring LCC during Operations Iraqi Freedom and Enduring Freedom was reviewed as a retrospective cohort. Primary outcome measures included final visual acuity (VA) and Ocular Trauma Score. Read More

J Stomatol Oral Maxillofac Surg 2018 Dec 21;119(6):489-492. Epub 2018 May 21.

Oral and Maxillofacial surgery department, North hospital, assistance publique hôpitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, France.

Introduction: Orbital haematomas threaten the visual prognosis, but no treatment guidelines have been proposed. Antithrombotics could affect their prognosis and treatment. This study aimed to evaluate the effect of antithrombotics in the management of orbital haematomas and to suggest a standardised protocol. Read More

Orbit 2018 May 4:1-4. Epub 2018 May 4.

a Department of Ophthalmology and Visual Sciences , University of Louisville , Louisville , Kentucky , USA.

Subperiosteal extension of a subgaleal hematoma (SGH) to the orbit is a reported, but rare complication of trauma. This report details a 13-year-old African-American male who originally presented to the emergency department after trauma with headache and was found on CT imaging to have a contained subgaleal hemorrhage. He presented 2 days later with increased pain and proptosis of the left eye with findings of decreased visual acuity, elevated intraocular pressure, proptosis, and complete external ophthalmoplegia. Read More

Ophthalmic Plast Reconstr Surg 2018 Sep/Oct;34(5):428-431

Cole Eye Institute, Cleveland Clinic, Cleveland.

Purpose: 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.

Methods: 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. Read More

Air Med J 2018 Jan - Feb;37(1):7-11

J R Army Med Corps 2018 May 10;164(2):133-138. Epub 2018 Jan 10.

Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.

Introduction: The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons.

Method: A systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma. Read More

Orbit 2018 Oct 8;37(5):361-363. Epub 2018 Jan 8.

b Department of Ophthalmology , Alice Springs Hospital , Alice Springs , Australia.

A 39-year-old male developed bilateral periorbital oedema and tense orbits in keeping with orbital compartment syndrome (OCS) shortly after presenting to the emergency department for uncontrollable epistaxis. Bilateral lateral canthotomy and inferior cantholysis was performed within 30 minutes of onset, with the left side further decompressed via superior cantholysis. Computed tomography demonstrated bilateral proptosis and optic nerve stretch, but no intraorbital haemorrhage or haematoma. Read More

Medicine (Baltimore) 2017 Dec;96(49):e9096

Department of Ophthalmology, Tri-Service General Hospital, Taipei City, Taiwan (R.O.C.).

Rationale: Orbital compartment syndrome (OCS) is a rare occurrence after transvenous embolization of indirect carotid-cavernous fistula (CCF). A lateral canthotomy and cantholysis are the most commonly performed surgical interventions. In our case, as the acute OCS occurred immediately after an uneventful transvenous embolization, an orbital floor orbitectomy was performed. Read More

World Neurosurg 2018 Jan 4;109:218-221. Epub 2017 Oct 4.

Department of Neurosurgery, Hospital Sírio Libanês, São Paulo, Brazil.

Introduction: Orbital compartment syndrome (OCS) is a rare condition characterized by increased intraorbital pressure and hypoperfusion of critical neural structures. It is usually associated with external ophthalmoplegia. We report a case of postoperative OCS following a frontotemporal craniotomy and review pertinent literature. Read More

Orv Hetil 2017 Sep;158(36):1410-1420

Fül-Orr-Gége és Szájsebészeti Osztály, Szent János Kórház és Észak-budai Egyesített Kórházak Budapest, Diós árok 1-3., 1125.

Introduction: Although orbital compartment syndrome is a rare condition, it is still the most common cause of blindness following simple or complicated facial fractures. Its pathomechanism is similar to the compartment syndrome in the limb. Little extra fluid (blood, oedema, brain, foreign body) in a non-space yielding space results with increasingly higher pressures within a short period of time. Read More

Eye (Lond) 2018 02 1;32(2):333-337. Epub 2017 Sep 1.

Orbital Service, Moorfields Eye Hospital, NHS Foundation Trust, London, UK.

PurposeThe lateral compartment of the orbit can readily be accessed through a horizontal lateral canthotomy without the need to swing the lid or remove bone. In this paper the technique, accessible orbital territory, and duration of surgery are presented.Patients and methodsRetrospective, non-interventional descriptive case series for patients who underwent a lateral canthotomy to access pathology within the lateral orbit. Read More

Emergencias 2017 Abr;29(2):122-125

Servicio de Oftalmología Hospital Universitario Miguel Servet, Zaragoza, España.

Objectives: Orbital emphysema, or the presence of air in orbital tissues, is normally associated with an injury although it can arise when a Valsalva maneuver causes an increase in upper airway pressure. This potential complication of an orbital wall fracture, usually in the ethmoid bone, occurs in 50% of such cases. On fracture, air passes from the nasal fossa, sinuses, or subcutaneous tissue. Read More

Curr Opin Ophthalmol 2017 Sep;28(5):470-476

Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Purpose Of Review: The current study reviews the recent literature on pediatric orbital blowout fractures and provides guidelines on their management.

Recent Findings: The most common problem among patients requiring surgical revision of a previously repaired orbital floor fracture is an improperly placed orbital floor implant, usually erroneously placed under the posterior bony ledge. Although the transconjunctival incision can be combined with a lateral canthotomy and cantholysis, excellent surgical exposure can be obtained without the need for these latter relaxing maneuvers. Read More

Craniomaxillofac Trauma Reconstr 2017 Sep 16;10(3):239-243. Epub 2016 Sep 16.

Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, United Kingdom.

Periorbital injury can present with various permutations of bone trauma, soft-tissue edema, and hematomas that might involve proptosis and restricted motility. We report a case of a 32-year-old patient who sustained a traumatic orbital compartment syndrome simultaneously with a large, significantly displaced, orbital-floor blow-out fracture. Clinical signs consistent with both conditions were elicited. Read More

Ophthalmic Plast Reconstr Surg 2017 Jul/Aug;33(4):313

Oral Maxillofac Surg 2017 Jun 18;21(2):187-192. Epub 2017 Mar 18.

Ahrar Hospital, Zagazig, Egypt.

Introduction: Although some studies addressed the differences between subciliary and transconjunctival approaches, no previous prospective comparative study on displaced zygomaticomaxillary complex (ZMC) fracture that repaired by three-point internal fixation using also upper gingivolabial incision and upper eye lid incision. So, the effect of these incisions on the comparison was not investigated.

Purpose: The purpose of this study was to compare transconjunctival and subciliary approaches for open reduction and internal rigid fixation (OR/IF) of ZMC fractures. Read More

J Craniofac Surg 2017 Jun;28(4):963-966

*Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang †Department of Ophthalmology, Guro Hospital, Korea University College of Medicine, Seoul ‡Department of Ophthalmology, Cheonan Chungmu Hospital, Cheonan §Department of Ophthalmology, KEPCO Medical Center, Seoul, Korea.

Purpose: To demonstrate the effectiveness of the endoscopic transcaruncular and transconjunctival approach in the repair of combined medial and inferior orbital wall fractures.

Methods: A retrospective chart review was conducted on 160 patients with combined medial and inferior orbital wall fractures. All patients underwent surgery via an endoscopic transcaruncular and transconjunctival approach without lateral canthotomy, performed by a single surgeon. Read More

J Craniofac Surg 2017 Mar;28(2):391-393

*Stockholms Craniofacial Center, Department of Reconstructive Plastic Surgery, Karolinska University Hospital †Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm ‡Department of Oral and Maxillofacial Surgery, Örebro University Hospital, Örebro, Sweden.

Background: Facial fractures may lead to sequelae due to the trauma but also as a result of surgery. Complications to lower eyelid incisions include ectropion, scleral show, entropion, canthal malposition, and lid edema. The aim of this study was to compare the occurrence of such complications depending on whether a subciliary or transconjunctival incision was used for surgical access. Read More

J Craniofac Surg 2016 Nov;27(8):2073-2077

*Department of Medicine and Surgery, Unit of Maxillofacial Surgery†Department of Medicine and Surgery‡Department of Medicine and Surgery, Unit of Plastic Surgery, University of Salerno, Salerno§Department of Medicine and Surgery, Unit of Maxillofacial Surgery, Antonio Cardarelli Hospital, Naples, Italy||Department of BioMolecular Sciences¶Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS.

Introduction: The zygomaticomaxillary complex is very vulnerable to injury because of its intrinsically prominent convexity. There are 2 different surgical approaches for the therapy of these fractures: closed reduction and open reduction. In the open reduction 2 or 3 fixation points with related incisions are usually necessary in dislocated fractures: osteosynthesis must be performed starting from zygomaticofrontal suture when dislocated at this site, followed by zygomatic body fixation on the anterior sinus wall, anterior orbital floor margin fixation, and finally orbital floor reconstruction in case of eye globe dislocation with diplopia. Read More

Ophthalmic Plast Reconstr Surg 2017 Sep/Oct;33(5):e110-e112

*Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; †Division of Neuroradiology, and ‡Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

An 89-year-old woman presented after blunt injury to the left orbit from a fall. Examination findings were suggestive of left-sided orbital compartment syndrome, unresponsive to emergent lateral canthotomy and cantholysis. CT revealed a left-sided orbital floor blowout fracture involving the infraorbital canal, with a large maxillary and infraorbital hematoma. Read More

J Maxillofac Oral Surg 2016 Sep 26;15(3):355-362. Epub 2015 Aug 26.

Department of Oral and Maxillofacial Surgery, V.S. Dental College and Hospital, K R Road, V V Puram, Bangalore, India.

Purpose: The aim of the study is to compare subciliary incision and 'sutureless' transconjunctival incision in the treatment of infraorbital rim fractures.

Materials And Method: In this prospective study, 40 patients with fractures of the infraorbital rim were selected and divided into 2 groups using random sampling technique. Group A patients were treated using 'sutureless' transconjunctival technique and group B patients were treated using subciliary approach. Read More

J Emerg Med 2017 Apr 8;52(4):557-558. Epub 2016 Oct 8.

Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi.

Background: The oculocardiac reflex is a decrease in heart rate caused by ocular compression or traction upon the extraocular musculature. Multiple instances of this phenomenon have been described in anesthesia, trauma, craniofacial, and ophthalmology literature, but there is a sparsity of documentation in the emergency medicine literature.

Case Report: We describe the observation and management of the oculocardiac reflex in a 26-year-old man with retrobulbar hematoma and intraocular trauma caused by a self-inflicted gunshot wound. Read More

Plast Reconstr Surg Glob Open 2016 May 27;4(5):e725. Epub 2016 May 27.

Department of Plastic and Reconstructive Surgery, Saga University Hospital, Saga, Japan.

Objective: To ask experts in the field to evaluate a surgeon's experience with a retroseptal transconjunctival approach for the repair of the orbital floor damaged by blowout fracture that the surgeon encountered in 12 East-Asian patients.

Methods: Patients were identified from a database, and a retrospective case note review was conducted. A total of 12 conjunctival procedures were conducted for the repair of blowout fracture with no other complicating fractures. Read More

Int J Oral Maxillofac Surg 2016 Nov 26;45(11):1435-1437. Epub 2016 Aug 26.

Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, Middlesex, UK.

Current guidelines for the urgent management of patients with orbital compartment syndrome include immediate lateral canthotomy and cantholysis, followed by surgical decompression. Medical treatment is also advocated to 'buy time' while preparing the patient for theatre. This consists of high-dose steroids, mannitol, and acetazolamide diuretics to reduce swelling and orbital pressure. Read More

Int J Surg 2016 Sep 30;33 Suppl 1:S9-S15. Epub 2016 May 30.

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy. Electronic address:

Introduction: The zygomaticomaxillary complex, with its intrinsically prominent convexity, is highly vulnerable to injury. In this study, we evaluated a novel combined approach to the reduction and stabilization of frontozygomatic dislocated fractures without aesthetic damage.

Materials And Methods: Ten patients (mean age, 52 years) were referred for complex frontozygomatic dislocated fractures. Read More

Craniomaxillofac Trauma Reconstr 2016 Jun 3;9(2):109-12. Epub 2015 Nov 3.

Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.

The aim of this study is to analyze the development of lower eyelid malposition following reconstruction of orbital fractures, in relation to the incisions used for access. A total of 198 surgical orbital floor reconstructions were performed in 175 patients between 2001 and 2011. Preoperative and postoperative presence of lower eyelid malposition of patients was reported. Read More

Oral Surg Oral Med Oral Pathol Oral Radiol 2016 Jul 16;122(1):e1-4. Epub 2016 Feb 16.

Assistant Professor, Oral and Maxillofacial Surgery, College of Dentistry, Ohio State University, Columbus, OH, USA.

Objective: Transconjunctival approach to the lower one-third of the orbit is commonly used to avoid transcutaneous incisions when surgical access is needed. A lateral canthotomy is used in conjunction with this approach if increased lateral exposure is required. A major disadvantage to lateral canthotomy is difficulty in resuspension of the lateral canthal tendon, which can lead to unaesthetic outcomes. Read More

Ophthalmic Plast Reconstr Surg 2017 Mar/Apr;33(2):93-100

*Oculoplastica Bernardini, Genova, Italy; †Cincinnati Eye Institute, Cincinnati, Ohio, USA; ‡Harvard Medical School, Boston, Massachusetts, USA; §Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.

Purpose: To review common surgical approaches to the orbital floor and to evaluate the utility of canthal-sparing, single incision transconjunctival method.

Methods: A retrospective chart review of a consecutive series of patients who underwent transconjunctival, direct incision surgery without eyelid dissection or lateral canthotomy and inferior cantholysis and review of the literature were conducted.

Results: Twenty-three consecutive patients (33 orbits) were operated using a canthal-sparing direct single cut approach, including 10 unilateral pediatric orbital floor fractures, 1 orbital floor implant removal, 2 unilateral post-traumatic enophthalmos repairs, and 10 bilateral orbital floor decompressions. Read More

Craniomaxillofac Trauma Reconstr 2016 Mar 19;9(1):46-54. Epub 2015 Aug 19.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.

We evaluate the safety and efficacy of the transcaruncular approach for reconstruction of medial orbital wall fractures and the combined transcaruncular-transconjunctival approach for reconstruction of large orbital defects involving the medial wall and floor. A retrospective review of the clinical and radiographic data of patients who underwent either a transcaruncular or a combined transcaruncular-transconjunctival approach by a single surgeon for orbital fractures between June 2007 and June 2013 was undertaken. Seven patients with isolated medial wall fractures underwent a transcaruncular approach, and nine patients with combined medial wall and floor fractures underwent a transcaruncular-transconjunctival approach with a lateral canthotomy. Read More

Am J Ophthalmol Case Rep 2016 Apr 10;1:8-10. Epub 2016 Feb 10.

Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA.

Purpose: To describe a complication of retrobulbar amphotericin B injections in the treatment of invasive rhino-orbital .

Observations: 27 year-old renal transplant recipient presented with a two-week history of headache, binocular diplopia and proptosis of the left eye. Endonasal biopsy on hospital day 3 confirmed the diagnosis of rhino-orbital invasive involving the left orbital apex. Read More

Br J Oral Maxillofac Surg 2016 07 3;54(6):707-9. Epub 2015 Dec 3.

Senior Resident, Oral and Maxillofacial Surgery Residency Program at Universidad El Bosque, Bogotá, Colombia.

Rev Stomatol Chir Maxillofac Chir Orale 2015 Dec 13;116(6):362-7. Epub 2015 Nov 13.

Department of surgery, service of maxillofacial and oral surgery, faculty of medicine, university hospital, Geneva, Switzerland. Electronic address:

Introduction: Orbital floor fractures may be reached through 2 types of conjunctival approaches, the preseptal one and the retroseptal one. While the retroseptal approach offers a more direct and easier route to the orbital rim and floor, it is associated with a significantly higher rate of lower lid complications compared to the preseptal approach. We will focus on the preseptal transconjunctival approach. Read More

Wilderness Environ Med 2016 Mar 12;27(1):85-91. Epub 2015 Nov 12.

Department of Emergency Medicine, University of Arizona, Tucson, AZ; Buecher Biological Consulting, Tucson, AZ (Mr Clemans).

Orbital compartment syndrome acutely threatens vision. Lateral canthotomy and cantholysis ameliorate the compartment syndrome and, to save a patient's vision, must be performed in a timely manner. This requires appropriate tools. Read More

Med J Malaysia 2015 Oct;70(5):316-7

Censelor Hospital Tuanku Muhriz, Ophthalmology Department, Universiti Kebangsaan Malaysia, Malaysia.

Orbital compartment syndrome (OCS) is a visual threatening ocular emergency. We report a 50-year-old male with acute presentation of OCS, a rare manifestation of idiopathic orbital inflammatory disease. At presentation, high intraocular pressure was reduced by prompt lateral canthotomy and cantholysis. Read More

Am J Otolaryngol 2015 Nov-Dec;36(6):828-31. Epub 2015 Aug 5.

Department of Otolaryngology - Head and Neck Surgery, Changi General Hospital, Singapore. Electronic address:

Background: Orbital compartment syndrome is a rare ocular emergency requiring immediate intervention to prevent vision loss. It can arise due to a variety of causes including trauma, neoplasms and retrobulbar hemorrhage during endoscopic sinus surgery. Lateral canthotomy and inferior cantholysis is a well-known therapeutic procedure to rapidly relieve raised intraocular pressures. Read More

J Craniomaxillofac Surg 2015 Sep 29;43(7):1000-3. Epub 2015 May 29.

Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264 rue St Pierre, 13385, Marseille, France; Aix-Marseille Université, Jardin du Pharo - 58, bd Charles Livon, 13284, Marseille Cedex 07, France; Laboratoire Parole et Langage (LPL), UMR 6057, France.

Introduction: Blindness is a rare and severe complication of craniofacial trauma. The management of acute orbital compartment syndrome (AOCS) is not well defined and there is no standard treatment. Our objective was to find indications for orbital decompression, the best time for treatment, and the appropriate techniques. Read More

Br J Ophthalmol 2016 Feb 17;100(2):204-8. Epub 2015 Jun 17.

Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK.

Background: Percutaneous sclerotherapy is an alternative to surgery for the treatment of orbital lymphatic malformations (LMs). We present a large series of patients undergoing sclerotherapy for macrocystic LMs with detailed visual acuity (VA) outcome data.

Methods: Data were collected prospectively in all patients with macrocystic orbital LMs undergoing sclerotherapy. Read More

J Craniofac Surg 2015 May;26(3):897-901

*Department of Head and Neck Surgery, Section of Maxillo Facial Surgery, San Paolo Hospital, University of Milan, Milan †G.B. Bietti Foundation for Study and Research in Ophthalmology-IRCCS, Rome ‡Department of Head and Neck Surgery, Section of Otolaryngology, San Paolo Hospital, University of Milan, Milan §Department of Head and Neck Surgery, Section of Ophthalmology, San Paolo Hospital, University of Milan, Milan ||Department of Health Sciences, Division of Oral Surgery, San Paolo Hospital, University of Milan, Milan, Italy.

Retrobulbar hemorrhage (RBH) is an uncommon complication of endoscopic sinus surgery or periorbital surgery consisting in an accumulation of blood within the orbit posteriorly to the eyeball. It must be treated within 90-100 minutes to avoid irreversible visual loss. The present paper tries to pinpoint the key steps in diagnosis and treatment of RBM. Read More

JAMA Otolaryngol Head Neck Surg 2015 Jun;141(6):562-5

Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.

Importance: Orbital compartment syndrome is an acute rise in intraorbital volume resulting in increased intraorbital pressure and possible ischemic compromise of the optic nerve. Tonometric pressure measurement of intraocular pressure can aid surgeons in the diagnosis of this condition and in choosing the need to proceed with emergent surgical intervention. In addition, we present an unexpected cause of orbital compartment syndrome following routine frontal sinus irrigation. Read More

Ophthalmic Plast Reconstr Surg 2017 May/Jun;33(3S Suppl 1):S118-S120

*Departments of Ophthalmology and Visual Neurosciences and †Department of Ophthalmology and Otolaryngology, University of Minnesota, Minneapolis, Minnesota.

A 64-year-old woman with relapsed acute myelogenous leukemia (AML) undergoing salvage chemotherapy developed rapid onset of right-sided ophthalmoplegia, proptosis, optic neuropathy, and vision loss from 20/30 to hand motions over a 3-hour period on day 4 of her treatment. CT scan of her orbits revealed a superolateral orbital mass and periocular edema. She underwent immediate canthotomy and cantholysis, and lateral orbitotomy with debulking of the mass later the same day. Read More

Ophthalmic Plast Reconstr Surg 2016 May-Jun;32(3):187-90

*Department of Ophthalmology, †Office of the University Veterinarian, Queen's University, Kingston, Ontario, Canada.

Purpose: To report the efficacy of intravenous mannitol in the treatment of orbital compartment syndrome.

Methods: An experimental study was conducted on 4 nonhuman primates (8 orbits). Orbital compartment syndrome was simulated by injecting autologous blood into both orbits of each nonhuman primate until a pressure of 80 mm Hg was reached (time 0). Read More

Curr Eye Res 2016 2;41(2):159-64. Epub 2015 Apr 2.

b Department of Ophthalmology , Gazi University Medical School , Ankara , Turkey.

Purpose: To compare the long-term visual outcomes after 2-wall (medial-lateral) versus 3-wall (medial-lateral-inferior) orbital decompression combined with fat removal in patients with dysthyroid optic neuropathy (DON).

Methods: Records of 68 eyes of 42 patients were retrospectively reviewed. Two-and 3-wall decompression was performed in 41 and 27 eyes, respectively. Read More