Emergency Lateral Canthotomy Followed by Orbital Septum Release for Traumatic Retrobulbar Hemorrhage: 2 Case Reports
Summary:. Retrobulbar hemorrhage can increase intraorbital pressure, thereby elevating intraocular pressure (IOP), inducing ischemia, and/or threatening the optic nerve. Emergent decompression is needed to preserve visual function. Multiple decompression methods that are favored by different clinica...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2025-03-01
|
| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006582 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849393843198230528 |
|---|---|
| author | Yosuke Ochi, MD Shimpei Ono, MD, PhD Rei Ogawa, MD, PhD |
| author_facet | Yosuke Ochi, MD Shimpei Ono, MD, PhD Rei Ogawa, MD, PhD |
| author_sort | Yosuke Ochi, MD |
| collection | DOAJ |
| description | Summary:. Retrobulbar hemorrhage can increase intraorbital pressure, thereby elevating intraocular pressure (IOP), inducing ischemia, and/or threatening the optic nerve. Emergent decompression is needed to preserve visual function. Multiple decompression methods that are favored by different clinical departments have been reported. Here, we report 2 emergency room cases of retrobulbar hemorrhage that were treated first with lateral canthotomy and inferior cantholysis (LC/IC) under local anesthesia followed an hour later by wide orbital septum release under general anesthesia. LC/IC permits the quickest possible decompression after injury, thus temporarily reducing IOP. Orbital septum release consolidates the decompression by permitting hematoma drainage and identification and hemostasis of the bleeding point. In our cases, IOP dropped from 55 and 52 mm Hg to 14 mm Hg in both cases, and corrected visual acuity improved from light perception/counting fingers to 20/20. Notably, LC/IC was only conducted 7 and 4 hours postinjury. This counters the commonly held view that decompression should occur within 2 hours of injury to achieve visual recovery. Thus, even though LC/IC followed by orbital septum release requires 2 surgical steps, it can result in excellent visual outcomes after retrobulbar hemorrhage. |
| format | Article |
| id | doaj-art-7bbf48043b2a4daebca37aa8176d0352 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-7bbf48043b2a4daebca37aa8176d03522025-08-20T03:40:17ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-03-01133e658210.1097/GOX.0000000000006582202503000-00007Emergency Lateral Canthotomy Followed by Orbital Septum Release for Traumatic Retrobulbar Hemorrhage: 2 Case ReportsYosuke Ochi, MD0Shimpei Ono, MD, PhD1Rei Ogawa, MD, PhD2From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.Summary:. Retrobulbar hemorrhage can increase intraorbital pressure, thereby elevating intraocular pressure (IOP), inducing ischemia, and/or threatening the optic nerve. Emergent decompression is needed to preserve visual function. Multiple decompression methods that are favored by different clinical departments have been reported. Here, we report 2 emergency room cases of retrobulbar hemorrhage that were treated first with lateral canthotomy and inferior cantholysis (LC/IC) under local anesthesia followed an hour later by wide orbital septum release under general anesthesia. LC/IC permits the quickest possible decompression after injury, thus temporarily reducing IOP. Orbital septum release consolidates the decompression by permitting hematoma drainage and identification and hemostasis of the bleeding point. In our cases, IOP dropped from 55 and 52 mm Hg to 14 mm Hg in both cases, and corrected visual acuity improved from light perception/counting fingers to 20/20. Notably, LC/IC was only conducted 7 and 4 hours postinjury. This counters the commonly held view that decompression should occur within 2 hours of injury to achieve visual recovery. Thus, even though LC/IC followed by orbital septum release requires 2 surgical steps, it can result in excellent visual outcomes after retrobulbar hemorrhage.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006582 |
| spellingShingle | Yosuke Ochi, MD Shimpei Ono, MD, PhD Rei Ogawa, MD, PhD Emergency Lateral Canthotomy Followed by Orbital Septum Release for Traumatic Retrobulbar Hemorrhage: 2 Case Reports Plastic and Reconstructive Surgery, Global Open |
| title | Emergency Lateral Canthotomy Followed by Orbital Septum Release for Traumatic Retrobulbar Hemorrhage: 2 Case Reports |
| title_full | Emergency Lateral Canthotomy Followed by Orbital Septum Release for Traumatic Retrobulbar Hemorrhage: 2 Case Reports |
| title_fullStr | Emergency Lateral Canthotomy Followed by Orbital Septum Release for Traumatic Retrobulbar Hemorrhage: 2 Case Reports |
| title_full_unstemmed | Emergency Lateral Canthotomy Followed by Orbital Septum Release for Traumatic Retrobulbar Hemorrhage: 2 Case Reports |
| title_short | Emergency Lateral Canthotomy Followed by Orbital Septum Release for Traumatic Retrobulbar Hemorrhage: 2 Case Reports |
| title_sort | emergency lateral canthotomy followed by orbital septum release for traumatic retrobulbar hemorrhage 2 case reports |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006582 |
| work_keys_str_mv | AT yosukeochimd emergencylateralcanthotomyfollowedbyorbitalseptumreleasefortraumaticretrobulbarhemorrhage2casereports AT shimpeionomdphd emergencylateralcanthotomyfollowedbyorbitalseptumreleasefortraumaticretrobulbarhemorrhage2casereports AT reiogawamdphd emergencylateralcanthotomyfollowedbyorbitalseptumreleasefortraumaticretrobulbarhemorrhage2casereports |