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Operative complications of optic nerve sheath decompression
1Department of Ophthalmology, Cleveland Clinic Foundation, OH 44195-5024.
Ophthalmology
|May 1, 1993
Summary
Optic nerve sheath decompression (ONSD) can cause complications, including temporary vision issues and rare but serious vascular events like central retinal artery occlusions (CRAOs). Patients should understand these risks before undergoing ONSD surgery.
Area of Science:
- Ophthalmology
- Neurosurgery
Background:
- Optic nerve sheath decompression (ONSD) is a surgical procedure for optic nerve dysfunction causing vision loss.
- Postoperative complications from ONSD are generally infrequent and mild.
Purpose of the Study:
- To review the spectrum and frequency of postoperative complications following ONSD.
- To assess the risk factors and outcomes associated with ONSD complications.
Main Methods:
- Retrospective review of 31 patients (38 eyes) undergoing ONSD surgery.
- Analysis of operative and postoperative courses.
- Evaluation of existing literature on ONSD complications.
Main Results:
- 40% of eyes experienced postoperative complications, primarily temporary motility and pupillary disorders.
- 11% of eyes had vascular complications, including two central retinal artery occlusions (CRAOs) with poor visual outcomes.
- Prior ONSD surgery increased the likelihood of vascular complications (P=0.025).
Conclusions:
- ONSD can lead to various complications, most minor and resolving without lasting effects.
- Serious complications like CRAO can cause significant visual impairment.
- Informed consent is crucial, discussing potential risks including visual morbidity.