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Endoscopically assisted transconjunctival decompression of traumatic optic neuropathy
Chien-Tzung Chen1, Faye Huang, Pei-kwei Tsay
1Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Institute of Technology, Chang Gung University, College of Medicine, Taoyuan, Taiwan. ctchenap@adm.cgmh.org.tw
The Journal of Craniofacial Surgery
|January 26, 2007
Summary
Endoscopic optic canal decompression improved vision in traumatic optic neuropathy (TON) patients unresponsive to steroids. Younger patients showed better visual outcomes, with minimal complications.
Area of Science:
- Ophthalmology
- Neurosurgery
- Maxillofacial Surgery
Background:
- Traumatic optic neuropathy (TON) is a severe complication of maxillofacial trauma.
- Corticosteroids are a common initial treatment, but surgical intervention may be necessary for persistent vision loss.
Purpose of the Study:
- To evaluate the efficacy and safety of endoscope-assisted transconjunctival optic canal decompression in patients with TON.
- To identify factors influencing visual outcome after surgical decompression.
Main Methods:
- Thirty patients with TON, unresponsive to corticosteroids, underwent endoscope-assisted transconjunctival optic canal decompression.
- Patients were stratified by initial visual acuity (light perception or better vs. no light perception) and timing of surgery.
- Surgical findings, including optic canal fractures, and postoperative outcomes were recorded.
Main Results:
- Vision improved in 12 patients (40%), including 6 with no light perception (28.6%) and 6 with light perception or better (66.7%).
- Average visual acuity improvement was 50%.
- Younger patient age was significantly correlated with better visual outcomes. Two patients experienced cerebrospinal fluid leakage.
Conclusions:
- Endoscope-assisted transconjunctival optic canal decompression is a safe and effective technique for improving vision in select TON patients.
- Early surgical intervention and patient age are critical factors for visual recovery.
- This minimally invasive approach offers a viable alternative for managing TON.
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