J Neurol Surg B Skull Base 2020; 81(04): 381-384
DOI: 10.1055/s-0040-1714077
Surgical Approaches to the Orbit
Review Article

Principles of Protection of the Eye and Vision in Orbital Surgery

Jenny C. Dohlman
1  Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
,
Michael K. Yoon
1  Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations

Abstract

Orbital surgery can result in damage to ocular and orbital structures, leading to a range of structural and visual sequelae, including corneal abrasions, globe malposition, diplopia, and blindness. Vision loss in particular is the most feared and devastating complication, occurs with an overall incidence of 0.84%, and can occur secondary to direct injury, optic nerve compression, or ischemic events. Different types of orbital surgery and surgical approaches carry their own hazards, and it is important to be mindful of these risks in addition to having a thorough understanding of individual risk factors and anatomical variations for each patient. Although universal guidelines for preserving vision in orbital surgery do not yet exist, there are concrete steps that every surgeon can take at the preoperative, intraoperative, and postoperative stages to minimize the risk of injury and maximize the likelihood of preserving the eye and visual function.



Publication History

Publication Date:
07 August 2020 (online)

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York