Unilateral blindness due to retrobulbar hematoma after lower blepharoplasty

Lee, Da Woon; Hong, Seok Won; Kim, Jun Hyuk

doi:10.14730/aaps.2019.01725

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Few studies have addressed the incidence of RBH after ophthalmic surgery, which is considered to have an extremely low incidence. Several case reports have been issued on the occurrence of postoperative RBH after oculoplastic surgery [1][2][3][4][5], and incidence rates of 0.055 to 3.2% have been reported, depending on type of surgery [6,7].…”

Section: Introductionmentioning

confidence: 99%

Incidence and management of retrobulbar hemorrhage after blowout fracture repair

2021

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Background Retrobulbar hemorrhage (RBH) is a rare complication after orbital surgery but associated with ocular complications including blindness. The aim of this study was to identify clinical characteristics of patients with RBH requiring emergent orbital decompression after blowout fracture repair. Method A retrospective review of 426 blowout fracture patients at a tertiary oculoplastic clinic provided data regarding demographics, physical examination findings, and computed tomography (CT) images. Extraocular motility had been recorded in patient charts on a scale from 0 to − 4. Patients requiring emergent orbital decompression due to RBH after surgery (RBH group) were compared with those who did not (Control group), using the Mann-Whitney U-test. Incidences of RBH according to primary or secondary surgery were also investigated, using Fisher’s exact test. Result Five (1.2%) of the 426 patients who underwent blowout fracture repair developed RBH requiring emergent intervention. All RBH patients fully recovered after the decompression procedure or conservative treatment. Number of days to surgery was significantly longer in the RBH group (97.0 ± 80.1) than in the Control group (29.0 ± 253.0) (p = 0.05). Preoperative enophthalmos was also significantly greater in the RBH group (RBH vs. Control group, 3.6 ± 1.7 mm versus 1.2 ± 1.3 mm (p = 0.003)). The incidence of RBH was significantly higher in patients that underwent secondary surgery (odds ratio = 92.9 [95% confidence interval, 11.16–773.23], p = 0.001). Conclusions Surgeons should pay more attention to hemostasis and postoperative care in patients with a large preoperative enophthalmic eye, when time from injury to surgery is long and in revision cases. When RBH occurs, time to intervention and surgical decompression is critical for visual recovery and preventing blindness. Trial registration The institutional review board of the Yeungnam University Medical Center approved this study (YUMC 2018-11-010), which was conducted in accord with the Declaration of Helsinki.

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Section: Introductionmentioning

confidence: 99%

Incidence and management of retrobulbar hemorrhage after blowout fracture repair

2021

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“…However, retrobulbar haemorrhage is a frequent cause. [ 2 ] This occurs in 0.055% and leads in 0.005% to permanent vision loss. In this case series, we present some literature cases of acute angle-closure glaucoma (ACG) and perioperative posterior ischaemic optic neuropathy (PION) [ Table 1 ].…”

Section: Introductionmentioning

confidence: 99%

Visual Loss after Cosmetic Blepharoplasty Using Local Anaesthesia Containing Epinephrine - A Case Series

Mommaerts

Kelen

2021

Annals of Maxillofacial Surgery

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Rationale: Surgeons should be aware of the risk of vision loss associated with blepharoplasty. Patient Concerns: All patients complained of decreased vision, redness and/or pain after blepharoplasty using only local anaesthesia containing epinephrine. Diagnosis: Diagnosis of angle-closure glaucoma (ACG) was made clinically (decreased visual acuity (VA), increased intraocular pressure and a mid-dilated pupil) and through examination (slit lamp examination and dynamic gonioscopy revealed corneal oedema and a shallow anterior chamber respectively). Perioperative posterior ischaemic optic neuropathy (PION) was a diagnosis of exclusion based on the relative afferent pupil defect. Treatment: ACG was treated medically (intravenous [IV] mannitol and topic antiglaucoma medication or oral acetazolamide) and surgically (YAG iridotomy and an additional cataract extraction with trabeculectomy in one patient). PION was treated with IV methylprednisolone. Outcome: Patients with ACG fully recovered. Patients with PION improved clinically, but presented with a pale optic disc and an optic nerve-related visual field defect. Take-Away Lesson: Surgeons should intervene quickly to minimize the chance of permanent vision loss.

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The Role of Blood Pressure Control in Prevention of Hematoma After Blepharoplasty

Ash,

Shauly,

Swan

et al. 2024

Aesth Plast Surg

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Unilateral blindness due to retrobulbar hematoma after lower blepharoplasty

Cited by 3 publications

References 10 publications

Incidence and management of retrobulbar hemorrhage after blowout fracture repair

Incidence and management of retrobulbar hemorrhage after blowout fracture repair

Visual Loss after Cosmetic Blepharoplasty Using Local Anaesthesia Containing Epinephrine - A Case Series

The Role of Blood Pressure Control in Prevention of Hematoma After Blepharoplasty

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