Clinical analysis of diagnosis and treatment of orbital cavernous hemangiomas / 中华实验眼科杂志

ABSTRACT

Background Orbital cavernous hemangiomas (OCH) is a common benign orbital tumor in adult,and accurate localization and diagnosis before operation supports the significant premise for surgical safety and success of tumor extraction.Objective This study was to research the clinical characteristics,preoperative diagnosis,the selection for different surgical approaches,therapeutic effectiveness and complication prevention of OCH.Methods The clinical data of 117 eyes of 117 patients with OCH who received surgery were retrospectively analyzed.The patients received surgery in Henan Eye Institute,Henan Eye Hospital from January 2011 to December 2014 and followed-up for 3 months to 5 years.The visual acuity,exophthalmos,ocular movement,orbital A/B ultrasound,color Doppler image,CT and MRI were examined before and after surgery.Results The primary clinical manifestations of OCH were gradual exophthalmos and impaired vision.The accordance rate of preoperative diagnosis and pathological diagnosis was 100％ in the group of patients.The surgical approachs included conjunctival approach in 52.14％ (61/117),lateral orbitectomy in 30.77％ (36/117),anterior approach in 16.24％ (19/117) and lateral combined with medial approach in 0.85％ (1/117).At the end of followed-up,visual acuity was significantly improved in 30.77％ (36/117),declined in 8.55％ (10/117) and unchanged in 60.68％ (71/117).Temporary complications after surgery were pupil dilatation in 14.53％ (17/117),emorrhoea in 1.71％ (2/117),ocular motility disorders in 16.24％ (19/117) and ptosis in 4.27％ (5/117).The permanent complications after operation were pupil dilatation in 2.56％ (3/117),visual loss in 0.85％ (1/117) and permanent abduction imitation in 0.85％ (1/117).Conclusions Accurate qualitative and site-specific diagnosis and correct choice of surgeries for OCH depend on clinical and iconographical examinations.Suitable surgical approach and operative skill are helpful to the therapeutic outcome and safety of OCH.