Ophthalmic complications associated with orthognathic surgery.
Ophthalmic complications are rare following maxillary osteotomies. Potential complications include a decrease in visual acuity, extraocular muscle dysfunction, neuroparalytic keratitis, and nasolacrimal problems involving both an increase or a decrease in tearing. Ophthalmic injuries appear to be primarily mediated through indirect injuries to neurovascular structures occurring from traction, compression, or contrecoup injuries from forces transmitted during the pterygomaxillary dysjunction using an osteotome or from fractures extending to the base of the skull or orbit associated with the pterygomaxillary dysjunction or the maxillary downfracture. A review of the literature of previous ophthalmic complications as well as eight new cases are reported. The possible etiologic basis for these injuries is discussed in detail as well as treatment possibilities when appropriate.
Lanigan
D T
DT
Division of Oral and Maxillofacial Surgery, University of Saskatchewan, Saskatoon, Canada.
Romanchuk
K
K
Olson
C K
CK
D000293:Adolescent; D000328:Adult; D005123:Eye / Q000098:blood supply; D005130:Eye Hemorrhage / Q000209:etiology; D005260:Female; D006801:Humans; D007634:Keratitis / Q000209:etiology; D007765:Lacrimal Apparatus / Q000293:injuries*; D008310:Malocclusion / Q000601:surgery; D008437:Maxilla / Q000601:surgery*; D015814:Ocular Hypotension / Q000150:complications / Q000209:etiology; D015835:Ocular Motility Disorders / Q000209:etiology*; D009801:Oculomotor Muscles / Q000293:injuries; D061220:Oculomotor Nerve Injuries; D020221:Optic Nerve Injuries; D009917:Orbital Fractures / Q000150:complications; D010027:Osteotomy / Q000009:adverse effects*; D014786:Vision Disorders / Q000209:etiology*