title: Compressive optic neuropathy after use of oxidized regenerated cellulose in orbital surgery: review of complications, prophylaxis, and treatment.
abstract: 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.
authors.affiliation: Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Yonca Ozkan
authors.initials: YO
authors.lastname: Arat
authors.forename: E Ulysses
authors.initials: EU
authors.lastname: Dorotheo
authors.forename: Rosa A
authors.initials: RA
authors.lastname: Tang
authors.forename: Milton
authors.initials: M
authors.lastname: Boniuk
authors.forename: Jade S
authors.initials: JS
authors.lastname: Schiffman
mesh_terms: 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
chemical_list: D002483:Cellulose, Oxidized; C013695:Surgicel