Dekompressionsoperation bei orbitalem Kompartmentsyndrom infolge Retrobulbärhämatom – Analyse von Operationsverfahren und Sehfunktion

Objective: Orbital compartment syndrome (OCS) can lead to acute visual function loss and high risk of permanent damage of the optic nerve. Orbital decompression surgery (ODS) is time critical as it aims to reduce the damaging orbital cavitiy pressure on the optic nerve. ODS techniques vary and consist of orbital fat decompression, lateral orbital wall, medial orbital wall and orbital floor decompression. The aim of this retrospective study was to analyse surgery procedures and the outcome of visual function after ODS. Methods: Different surgery procedures and outcome of visual function after ODS were analysed. 21 patients with OCS and confirmed vision impairment were enrolled in a retrospective study. All patients underwent orbital decompression surgery as first line treatment. Visual function was analysed pre- and postoperative. Recovery was defined as postoperative visus improvement.Results: ODS was carried out after a median time of 0,6 days (range 0,1 - 3 days) upon occurrence of OCS symptoms. Average preoperative visus was 0,2. 76% (16/21) of patients had a severe visual function loss (visus < 0,1). Postoperative visual function improved in 48% (10/21) of patients. Main surgery technique was 2-wall-decompression in 76% (16/21) of cases followed by 3-wall-decompression (14%; 3/21) and 1-wall-decompression (5%; 1/21). Lateral wall decompression (95%; 20/21) and medial wall decompression (90%; 19/21) were mostly performed. Orbital floor decompression was performed in 19% (4/21) of cases. Conclusion:ODS is a valuable time critical tool in the first line treatment of OCS. Our data showed visual function improvement in 48% of patients. Main surgery technique was a 2-wall-decompression approach with lateral wall decompression and medial wall decompression.

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