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Advantages of Early Surgical Management of Periorbital Infantile Hemangiomas
Kimberly Chan1,2, Teresa O1,3, Caroline Broude1
1Vascular Birthmark Institute of New York, New York, New York, USA.
Insights
Early surgical treatment of periorbital infantile hemangiomas (POIH) can reverse anisoastigmatism. However, earlier intervention did not significantly improve overall eye symmetry in patients with POIH.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Dermatology
Background:
- Periorbital infantile hemangiomas (POIH) require prompt management to prevent vision-threatening complications.
- Early intervention in POIH is linked to reduced ophthalmological issues.
Purpose of the Study:
- To assess the impact of age and patient characteristics on resolving anisometropic astigmatism (anisoastigmatism) and improving eye symmetry.
- To evaluate outcomes in patients with POIH treated with surgical excision.
Main Methods:
- Retrospective analysis of 54 patients diagnosed with POIH.
- Comparison of patient demographics and eye symmetry between resolved and unresolved anisoastigmatism groups post-surgery.
- Statistical analysis using Mann-Whitney U tests, chi-square tests, and linear regression.
Main Results:
- Anisoastigmatism resolved postoperatively in 56% of patients.
- Earlier surgical evaluation (median 4.5 months) and excision (median 5.0 months) correlated with anisoastigmatism resolution.
- No significant association was found between earlier surgical excision and improved eye symmetry.
Conclusions:
- Early surgical excision of POIH is effective in reversing anisoastigmatism.
- Surgical timing does not appear to significantly influence the improvement of eye symmetry in these patients.
Abstract:
Background: Early evaluation and treatment of periorbital infantile hemangiomas (POIH) were associated with lower rates of ophthalmological complications. Objective: To evaluate age and characteristics associated with improved anisometropic astigmatism (anisoastigmatism) and eye symmetry measured by diopters and a 5-point scale, respectively, in patients with POIH treated with surgical excision. Methods: A retrospective study was performed on patients with POIH. Patient characteristics and eye symmetry were analyzed between patients with resolved and unresolved anisoastigmatism after surgery. Statistical analyses included the Mann-Whitney U tests, chi-square tests, and linear regression models. Results: In total, 54 patients were included (male: 20, female: 34). Upper medial eyelid was the most commonly affected site (resolved: 45%, unresolved: 43%), followed by upper lateral and upper central. Fifty-six percent (31/55) had postoperative resolution of anisoastigmatism, whereas 44% (24/55) did not. Earlier surgical evaluation (median: 4.5 vs. 6.0 months, p = 0.047) and excision (median: 5.0 vs. 12.0 months, p = 0.005) were associated with reversible anisoastigmatism. Good and suboptimal eye symmetry were not associated with earlier surgical excision (median: 6 vs. 6.5 months, p = 0.87). Follow-up ranged from 1 month to 12 years. Conclusion: Earlier surgical excision was associated with reversing anisoastigmatism but was not significant for improving eye symmetry.
