Endoscopic Transethmosphenoid Optic Canal and Orbital Apex Decompression for Patients With Traumatic Orbital Apex...

The aim of this study was to evaluate the efficacy, feasibility, and safety of the endoscopic optic canal and orbital apex decompression for patients with traumatic orbital apex syndrome.

Retrospective, noncomparative case series.

Thirty-one patients (31 eyes) with traumatic orbital apex syndrome underwent endoscopic transethmosphenoid optic canal and orbital apex decompression at the Eye Hospital of Wenzhou Medical University from May 1st, 2012 to May 1st, 2018. In each case, the indication of surgery was that patient with traumatic orbital apex syndrome failed to respond to corticosteroids. Patients were followed up to 6 months after surgery. Best corrected visual acuity, visual field, ptosis, ophthalmoplegia, hypoesthesia, and pupil before and after surgery were compared.

All patients presented visual decline (including 5 patients with no light perception), ptosis, ophthalmoplegia, diplopia, pupil dysfunction, and visual field defect, and 20 of them also presented hypoesthesia. Nineteen of 31 (61.3%) patients gained improvement of best-corrected visual acuity after surgery, 7 of them gained 20/20 BCVA, and visual field showed improvement in 20 patients. Ptosis and ophthalmoplegia of all patients recovered in various degree; diplopia also relieved relatively. The function of the pupil was also improved in most patients (27/31, 87.1%). The improvement of hypoesthesia was also observed in most patients. No serious complications occurred.

Endoscopic transethmosphenoid optic canal and orbital apex decompression seems to be a feasible, efficient, and safe approach for traumatic orbital apex syndrome patients.