Compressive Optic Neuropathy after Use of Oxidized Regenerated Cellulose in Orbital Surgery: Review of Complications, Prophylaxis, and Treatment
Presented as a poster at: Joint Meeting of the American Academy of Ophthalmology and European Society of Ophthalmology, October 23–26, 2004; New Orleans, Louisiana, and American Society of Ophthalmic Plastic and Reconstructive Surgery 35th Annual Scientific Symposium, October 22–23, 2004; New Orleans, Louisiana.
Received 19 April 2005; accepted 1 November 2005. published online 09 January 2006.
Purpose
We report 2 cases of compressive optic neuropathy after use of oxidized regenerated cellulose (ORC) in orbital surgery. To our knowledge, no complications have been reported previously after use of this material in orbital surgery. We also review the complications related to its retention at operative sites outside the orbit and recommend precautions to avoid them.
Design
Retrospective interventional case reports.
Participants
Two patients with compressive optic neuropathy after use of ORC in orbital surgery.
Methods
Case reports from 2 different clinics and review of the English scientific literature.
Main Outcome Measures
Best-corrected visual acuity, extraocular motility, proptosis, and chemosis.
Results
One patient underwent orbital exploration and biopsy of an orbital tumor, and the second had repair of an orbital floor fracture. Postoperatively, both presented with chemosis, ophthalmoplegia, and progressive loss of vision. Orbital imaging revealed a retrobulbar soft-tissue density compatible with hematoma. Repeat orbital exploration revealed the soft-tissue mass to be swollen ORC.
Conclusions
Retained intraorbital ORC may cause a compartment syndrome and should be suspected in postoperative patients with orbital symptoms. When ORC is used around the optic nerve, it should be removed after hemostasis is achieved.
ABSTRACT