Treatment outcomes of lateral canthotomy and cantholysis for orbital compartment syndrome

Timlin, Hannah; Bell, Suzannah; Uddin, Jimmy; Osborne, Sonya

doi:10.1016/j.bjoms.2019.04.008

Cited by 9 publications

(6 citation statements)

References 4 publications

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“…Complications such as retroocular hemorrhage may occur when introducing large needles into the orbit. If this occurs, a canthotomy, cantholysis, and septolysis can be performed to release intraorbital pressure and reduce proptosis generated by the orbital compartment syndrome induced 15,16 …”

Section: Resultsmentioning

confidence: 99%

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The M.A.STE.R.S algorithm for acute visual loss management after facial filler injection

Graue¹,

Araujo²,

Palazuelos³

et al. 2020

J of Cosmetic Dermatology

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Objective To propose an algorithm of treatment for sudden visual loss following filler injections and perform an English‐written literature search for assignment of evidence level and grade recommendation. Methods Algorithm of treatment includes ocular physical Maneuvers, hyAluronidase administration, intravenous STEroids, intraocular pressure Reduction, and Supplemental Oxygen (M.A.STE .R.S) based on previous acute management reports. Special consideration for algorithm buildup was made for ophthalmic diseases that share physiopathological features such as central retinal artery occlusion, systemic vasculitis affecting vision, and acute glaucoma. Finally, a systematic cross‐review of the reported cases with visual loss was done to identify the level of evidence and grant a recommendation grade. Results A search through PubMed and Medscape databases for English‐written scientific papers using the terms facial filler, retinal artery occlusion, management, treatment, complications, and adverse events quoted a total of 46 papers (190 cases) which were then analyzed. A high variability on management for treatment of sudden visual loss after facial filler injections was observed. This was attributed partially to the great diversity of medical specialists performing cosmetic facial procedures such as dermatologists, plastic surgeons, esthetic doctors and ophthalmologists, and the lack of high evidence level studies. Conclusions The proposed algorithm provides an initial guideline based on prior literature reports and physiopathology involving facial filler injection complications. Analysis identified 22 successfully treated cases with vision recovery (11.57%). Ocular physical maneuvers had the best evidence‐based level and grade recommendation (A) for the management of acute vision loss secondary to facial filler injections.

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Section: Resultsmentioning

confidence: 99%

“…If this occurs, a canthotomy, cantholysis, and septolysis can be performed to release intraorbital pressure and reduce proptosis generated by the orbital compartment syndrome induced. 15,16…”

Section: Hyaluronidase Administrationmentioning

confidence: 99%

The M.A.STE.R.S algorithm for acute visual loss management after facial filler injection

Graue¹,

Araujo²,

Palazuelos³

et al. 2020

J of Cosmetic Dermatology

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show abstract

“…On the other hand, delayed presentation after traumatic injury should not prevent the emergency physician from performing the pro- 20 Furthermore, Bailey et al determined that 60% had improvement in vision with LCIC beyond 3 hours. 4 There are reports of vision recovery after delayed decompression, 4,20,[43][44][45][46][47] even up to 5 days. 48…”

Section: Pitfall #2 -Delaying Definitive Surgical Treatment For Any Reasonmentioning

confidence: 99%

“…Because the primary objective of LCIC is to treat OCS, reduce IOP, and improve retinal perfusion, IOP should be measured immediately after performing the procedure. LCIC does not always adequately decrease IOP 47. If it is still elevated, then superior cantholysis can be performed.…”

mentioning

confidence: 99%

Orbital compartment syndrome: Pearls and pitfalls for the emergency physician

et al. 2021

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Orbital compartment syndrome (OCS) is a rare, vision‐threatening diagnosis that requires rapid identification and immediate treatment for preservation of vision. Because of the time‐sensitive nature of this condition, the emergency physician plays a critical role in the diagnosis and management of OCS, which is often caused by traumatic retrobulbar hemorrhage. In this review, we outline pearls and pitfalls for the identification and treatment of OCS, highlighting lateral canthotomy and inferior cantholysis (LCIC), a crucial skill for the emergency physician. We recommend adequate preparation for the diagnosis and procedure, early consultation to ophthalmology, clear and thorough documentation of the physical examination, avoidance of iatrogenic injury during LCIC, and complete division of the inferior canthal tendon. Emergency physicians should avoid failing to make the diagnosis of OCS, delaying definitive surgical treatment, overrelying on imaging, failing to decrease intraocular pressure, and failing to exclude globe rupture. The emergency physician should be appropriately trained to identify signs and symptoms of OCS and perform LCIC in a timely manner.

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“…Orbital compartment syndrome (OCS) is an ophthalmic emergency that describes an increase in intraorbital volume and pressure, resulting in retinal ischemia [1,2]. Within two hours, patients may experience irreversible vision loss, unless the condition is quickly recognized and treated.…”

Section: Introductionmentioning

confidence: 99%

Orbital Compartment Syndrome: How a Young Man’s Vision was Saved by the Timely Actions of an Emergency Medicine Physician

Houck¹,

Mangal²,

Vandillen³

et al. 2019

Cureus

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In the following case presentation, a young man who incurred orbital compartment syndrome (OCS) from physical trauma significantly improved from timely lateral canthotomy. Lateral canthotomy is recommended to be performed as soon as possible to avoid permanent vision loss, which is the most feared complication associated with orbital compartment syndrome. This procedure completely restored vision in the patient and permitted prompt discharge.

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Treatment outcomes of lateral canthotomy and cantholysis for orbital compartment syndrome

Cited by 9 publications

References 4 publications

The M.A.STE.R.S algorithm for acute visual loss management after facial filler injection

The M.A.STE.R.S algorithm for acute visual loss management after facial filler injection

Orbital compartment syndrome: Pearls and pitfalls for the emergency physician

Orbital Compartment Syndrome: How a Young Man’s Vision was Saved by the Timely Actions of an Emergency Medicine Physician

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