Most Read Articles
22 hours ago
Use of potassium citrate and thiazides appears to improve health-related quality of life (HRQOL) among stone formers across all Wisconsin Stone Quality of Life (WISQOL) domains without increasing the likelihood of gastrointestinal complaints and fatigue or sexual complaints, respectively, reports a study.
Pearl Toh, 4 days ago
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
2 days ago
Eating high amounts of red and processed meat prior to a diagnosis of colorectal cancer appears to be associated with shorter survival time, although a possible weak association cannot be excluded, a study has shown.
Yesterday
Middle-aged Caucasian men who are dissatisfied with their marriage are at higher risk of sudden cardiac death regardless of other cardiovascular risk factors, a new study reports.

Blindness risk after surgery high in patients undergoing orbital floor repair, bony decompression

27 Jul 2018

A recent study has shown a 0.84-percent overall risk of severe vision loss following orbital surgery, and subgroup risk is higher in patients undergoing facial polytrauma repair, optic canal decompression or orbital apex surgery from an intracranial approach.

“Close postoperative monitoring and urgent assessment and management of acute vision loss may improve visual outcome in some patients,” the investigators said.

Orbital surgery was performed in 1,665 patients during the study period. Of these, 14 sustained severe vision loss ranging from counting fingers at 1 foot to no light perception (overall risk, 0.84 percent). The causes of vision loss were as follows: retrobulbar haemorrhage, malpositioned implant, optic nerve ischaemia or direct optic nerve insult.

Stratification by surgical approach showed a significantly greater risk of a blinding surgical complication for patients undergoing orbital floor repair in the setting of multiple facial fractures (subgroup risk, 6.45 percent), bony decompression of the optic canal (subgroup risk, 15.6 percent) or intracranial approach to the orbital roof (subgroup risk, 18.2 percent).

Eight patients had a potentially reversible cause of postoperative vision loss, of which seven underwent urgent repeat surgery and two regained substantial vision (20/20 and 20/25). Furthermore, there was no significant effect on visual acuity outcome with administration of intravenous corticosteroids.

The investigators searched a billing database, cross-checked against diagnostic codes related to vision loss, to identify all patients who had orbital surgery during the study period. They also screened charts to determine baseline demographic and medical history, surgical procedure, intraoperative and perioperative management, and visual acuity.

A detailed review was performed among patients with preoperative visual acuity ≥20/200 that worsened ≤20/400 after orbital surgery. Factors posing a particular risk or benefit to visual outcome in these patients were identified using statistical analysis.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
22 hours ago
Use of potassium citrate and thiazides appears to improve health-related quality of life (HRQOL) among stone formers across all Wisconsin Stone Quality of Life (WISQOL) domains without increasing the likelihood of gastrointestinal complaints and fatigue or sexual complaints, respectively, reports a study.
Pearl Toh, 4 days ago
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
2 days ago
Eating high amounts of red and processed meat prior to a diagnosis of colorectal cancer appears to be associated with shorter survival time, although a possible weak association cannot be excluded, a study has shown.
Yesterday
Middle-aged Caucasian men who are dissatisfied with their marriage are at higher risk of sudden cardiac death regardless of other cardiovascular risk factors, a new study reports.