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Traumatic globe luxation with optic nerve transection
Mandeep S. Bajaj1, Sachin Kedar, Anita Sethi
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
Orbit (Amsterdam, Netherlands)
|June 5, 2002
Summary
Globe luxation, a severe orbital trauma, can be surgically managed by repositioning the intact globe. This case highlights successful globe repositioning despite optic nerve transection, improving cosmesis and psychological recovery.
Area of Science:
- Ophthalmology
- Trauma Surgery
- Orbital Surgery
Background:
- Globe luxation is a rare, severe orbital trauma often associated with orbital fractures.
- While globe rupture typically necessitates enucleation, intact globes may be repositioned.
- Optic nerve transection presents a significant challenge in managing globe luxation.
Purpose of the Study:
- To report the surgical management of a rare case of globe luxation with optic nerve transection.
- To evaluate the outcomes of globe repositioning and muscle reattachment in severe orbital trauma.
Main Methods:
- A 17-year-old male with anterior globe luxation and optic nerve transection underwent surgical exploration.
- Computerized tomography confirmed globe subluxation, optic nerve transection, and orbital wall fractures.
- Surgical intervention involved globe repositioning and reattachment of ocular muscles.
Main Results:
- Postoperative repositioning of the globe was achieved with moderate motility.
- Excellent overall cosmetic results were observed.
- The patient experienced significant psychological recovery due to globe preservation.
Conclusions:
- Surgical repositioning of an intact globe is feasible even with optic nerve transection.
- While visual prognosis is often poor, globe preservation significantly improves cosmesis and psychological well-being.
- This approach offers a viable alternative to enucleation in select cases of severe orbital trauma.