Related Experiment Videos
Risk factors associated with complications of orbital surgery in children
Insights
Orbitotomies in children have a high complication rate, especially secondary procedures and those involving intraconal lesions. Dense amblyopia is a significant concern, impacting visual outcomes in pediatric orbital surgery.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Orbitotomies are surgical procedures to access orbital lesions or for orbital decompression.
- Pediatric orbital surgery presents unique challenges due to smaller anatomical structures and potential for amblyopia.
Purpose of the Study:
- To evaluate the overall complication rate of orbitotomies in pediatric patients.
- To identify the types of complications and associated risk factors in children undergoing orbitotomies.
Main Methods:
- A retrospective review of 33 orbitotomies performed on 30 children under 13 years of age.
- Surgical procedures for space-occupying lesions or orbital decompression were analyzed.
- Outcomes were assessed with an average follow-up of 2.5 years.
Main Results:
- Complication rates varied by surgical approach: 20% for anterior, 40% for primary lateral, and 100% for secondary orbitotomies.
- Major complications included frozen eyeball, diplopia, and ptosis; minor complications involved enophthalmos and dry eye.
- Dense amblyopia occurred in 6 of 9 patients, and 6 patients required further ocular surgery.
Conclusions:
- Pediatric orbitotomies carry a significant risk of complications, influenced by factors like small orbit size and lesion type.
- Secondary procedures and intraconal lesions were identified as major risk factors for complications.
- The development of dense amblyopia complicates visual prognosis in pediatric cases.
Purpose:
To assess the overall complication rate of orbitotomies performed in children and to determine the nature of complication to identify possible risk factors.
Methods:
Thirty children <13 years underwent 33 orbitotomies for space-occupying lesions of the orbit or orbital decompression. A detailed evaluation of the surgical procedures and outcomes was conducted. Follow up averaged 2.5 years (range: 6 months to 5 years).
Results:
The complication rate was 20% (2 of 10 cases) for anterior orbitotomies, 40% (8 of 20 cases) for primary lateral orbitotomies, and 100% (3 of 3 cases) for secondary orbitotomies. Dense amblyopia was noted in 6 of 9 patients. Major complications were frozen eyeball, diplopia, and ptosis. Less serious complications were enophthalmos, internal ophthalmoplegia, dry eye, and eyelid retraction. Six patients underwent extraocular surgery, levator muscle surgery, or both at a later date.
Conclusion:
Although the scope of complications is the same in children as in adults, the frequency of cystic benign lesions and small orbits in children can cause more frequent serious complications. Additionally, dense amblyopia of a complicated nature makes visual outcome unpredictable. The most significant risk factors identified were the need for a secondary procedure for recurring pathology and the presence of an intraconal lesion.