Vertical Lid Split Orbitotomy for Management of Orbital Compartment Syndrome-A Clinical Case Series.

PURPOSE: This study aims to investigate the early use of a vertical lid split orbitotomy for the management of orbital compartment syndrome.

METHODS

This was a retrospective study of all patients in the authors' center who had a vertical lid split procedure for orbital compartment syndrome. Intraocular pressure was measured before and after completion of the procedure as a surrogate for orbital pressure. Information regarding the mechanism of injury as well as the ophthalmic exam was reviewed.

RESULTS

Ten patients were included, 3 of which were bilateral, for a total of 13 eyes. The average age of the patients was 46.4 years (19-2 years). Gunshot wounds were the most common mechanism of injury (40%). Five eyes in 4 patients had prior failed canthotomy and cantholysis prior to presentation by an outside provider. The average intraocular pressure prior to intervention was 52.5 mm Hg (39-60 mm Hg). Average postintervention intraocular pressure was 21.7 mm Hg, with all patients achieving adequate reduction of pressure below 30 mm Hg (15-27 mm Hg). This resulted in an average reduction in pressure of 30.8 mm Hg (20-36 mm Hg), or 58.7%. No patients in the study had iatrogenic globe injury.

CONCLUSIONS

Orbital compartment syndrome poses a time-sensitive threat to vision. This is the first study of the use of the vertical lid split to decompress the orbit in a clinical setting.