Compressive optic neuropathy after use of oxidized regenerated cellulose in orbital surgery: review of complications, prophylaxis, and treatment.
OBJECTIVE
We report 2 cases of compressive optic neuropathy after use of oxidized regenerated cellulose (ORC) in orbital surgery. To our knowledge, no complications have been reported previously after use of this material in orbital surgery. We also review the complications related to its retention at operative sites outside the orbit and recommend precautions to avoid them.


METHODS
Retrospective interventional case reports.


METHODS
Two patients with compressive optic neuropathy after use of ORC in orbital surgery.


METHODS
Case reports from 2 different clinics and review of the English scientific literature.


METHODS
Best-corrected visual acuity, extraocular motility, proptosis, and chemosis.


RESULTS
One patient underwent orbital exploration and biopsy of an orbital tumor, and the second had repair of an orbital floor fracture. Postoperatively, both presented with chemosis, ophthalmoplegia, and progressive loss of vision. Orbital imaging revealed a retrobulbar soft-tissue density compatible with hematoma. Repeat orbital exploration revealed the soft-tissue mass to be swollen ORC.


CONCLUSIONS
Retained intraorbital ORC may cause a compartment syndrome and should be suspected in postoperative patients with orbital symptoms. When ORC is used around the optic nerve, it should be removed after hemostasis is achieved.
Arat
Yonca Ozkan
YO
Baylor College of Medicine, Houston, Texas, USA.
Dorotheo
E Ulysses
EU
Tang
Rosa A
RA
Boniuk
Milton
M
Schiffman
Jade S
JS
D000293:Adolescent; D000368:Aged; D002483:Cellulose, Oxidized / Q000009:adverse effects*; D005094:Exophthalmos / Q000175:diagnosis / Q000209:etiology; D005129:Eye Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D009917:Orbital Fractures / Q000601:surgery; D009918:Orbital Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology; D014792:Visual Acuity
D002483:Cellulose, Oxidized; C013695:Surgicel