Lateral orbitotomy for traumatic optic neuropathy and traumatic opthalmoplegia: Is it beneficial?

ABSTRACT

This was a retrospective study of 12 eye injuries concomitant with closed head injury, that were treated by the authors in Sanglah General Hospital, Bali during 2008. The purpose of this study was to evaluate the efficacy of lateral orbitotomy for nerve compression in eye injuries. Optic nerve compression at the optic canal can cause traumatic optic neuropathy; and nerve compression of 3rd, 4th and 6th nerves at the superior orbital fissure can cause traumatic ophthalmoplegia. Optic nerve decompression with steroids or surgical interventions or both have therefore been advocated to improve visual prognosis in traumatic optic neuropathy. To date it is not known whether lateral orbitotomy is beneficial in these traumatic injuries. There were 12 patients in this study, consisting of 11 males and 1 female with diagnosis of traumatic optic neuropathy in 10 patients and traumatic ophthalmoplegia in 2. Lateral orbitotomy procedures were done and all patients were also given high doses of steroids preoperatively. The mean visual improvement ratio was 43.3 ± 22.3. Ten patients improved (83.3 %) and 2 patients did not. There were no clinical deterioration and side effects from the operative procedure. This study suggests that lateral orbitotomy may possibly be beneficial as treatment for traumatic optic neuropathy and ophthalmoplegia.