Comparison of the Effects of Conventional and Ultrasonic Bone Cutting in Septorhinoplasty Surgery on Intraocular Pressure in the Postoperative Period

Abstract

Introduction

Septorhinoplasty is a complex facial surgery that involves osteotomy, a procedure that can lead to complications such as postoperative edema, ecchymosis, and potential changes in intraocular pressure (IOP). However, there is limited research on how different osteotomy techniques, such as conventional osteotomy versus ultrasonic bone cutting, affect IOP.

Objectives and Hypotheses

This study aimed to compare the effects of conventional osteotomy and ultrasonic bone cutting on IOP in patients undergoing septorhinoplasty. We hypothesized that ultrasonic osteotomy would result in less change in IOP compared to conventional osteotomy.

Study Design

Prospective, double-blind, randomized, controlled study conducted at a tertiary referral hospital in Turkey. The study adhered to the CONSORT guidelines for randomized trials.

Methods

Sixty patients undergoing septorhinoplasty were randomly assigned to either the conventional osteotomy group or the ultrasonic osteotomy group. IOP was measured preoperatively, on postoperative day 1, and on postoperative day 7 using noncontact tonometry. Statistical analyses were performed using SPSS version 25.0 with repeated measures analysis.

Results

No significant difference in IOP was observed between groups on postoperative day 7. However, the conventional osteotomy group showed a significant increase in IOP on postoperative day 1 (p < 0.001), with a subsequent decrease by day 7. The ultrasonic osteotomy group showed no significant IOP change.

Conclusion

Ultrasonic bone cutting for osteotomy in septorhinoplasty results in more stable IOP compared to conventional osteotomy, making it potentially safer for patients at risk of glaucoma. Further studies with longer follow-ups are required to confirm these findings.

Keywords

rhinoplasty - intraocular pressure - osteotomy - piezosurgery - tonometry

Publication History

Accepted Manuscript online:
16 April 2025

Article published online:
19 May 2025

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