Abstract
Objectives
Traumatic optic neuropathy is a devastating condition characterised by a loss of vision
following trauma. The present study was designed to evaluate the visual results after
surgical decompression of the optic nerve using a minimally invasive trans-caruncular
trans-orbital approach.
Patients and Methods
A retrospective study was designed to study the visual improvement in patients with
traumatic optic neuropathy who underwent optic canal decompression by the trans-caruncular/transorbital
route. Twenty five patients who presented with reduced vision following trauma and
no improvement despite conservative management were included in the study. Patients
with life threatening conditions, as well as those who did not have a record of visual
assessment at presentation were excluded from the study. Patients with optic atrophy
at presentation were also excluded. All patients underwent the surgical decompression
under local anaesthesia. Visual function was assessed before and at 2 weekly intervals
after surgery.
Results
The mean age of the patients in the study was 30 ± 7.83 years with 21 males (84%)
and 4 females (16%). The mean preoperative vision was 3.02 ± 1.81 LOGMAR. 13 patients
(52%) had no perception of light at presentation. The mean postoperative vision was
0.58 ± 0.53 (range of 0.2-2 LOGMAR). The mean percentage improvement was 65.06 ± 27.69%.
Three patients (23%), with no perception of light at presentation, had no improvement
in vision.
Conclusion
The minimally invasive trans-caruncular, trans-orbital approach to the decompression
of the optic nerve in traumatic optic neuropathy is a useful technique with good visual
results. This may be performed with under local anaesthesia with rapid postoperative
rehabilitation.
Keywords
traumatic optic neuropathy - optic canal decompression - transcaruncular/orbital optic
canal decompression - minimal invasive orbital surgery
