title: Update on orbital decompression as emergency treatment of traumatic blindness.
abstract: BACKGROUND
  Blindness is a rare and severe complication of craniofacial trauma. The management of acute orbital compartment syndrome (AOCS) is not well defined and there is no standard treatment. Our objective was to find indications for orbital decompression, the best time for treatment, and the appropriate techniques.
  
  
  METHODS
  A literature review was made from articles published between 1994 and 2014 in the PubMed database, on the emergency treatment of AOCS.
  
  
  RESULTS
  59 of the 89 patients treated surgically for AOCS presented with significant improvement of visual acuity (VA) after orbital decompression. The delay between trauma and surgery was short. A lateral canthotomy with inferior cantholysis (LCIC) was the most frequently used technique.
  
  
  CONCLUSIONS
  AOCS with a risk of visual impairment must be decompressed in emergency, at best in the 2 hours following trauma, most often by LCIC to have the best chance of recovering VA. Adjuvant medical treatment (acetazolamide, mannitol, corticosteroids) should not delay surgery. Postoperative corticosteroid therapy is not indicated, especially in patients with severe head trauma.
authors.affiliation: Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264 rue St Pierre, 13385, Marseille, France; Aix-Marseille Université, Jardin du Pharo - 58, bd Charles Livon, 13284, Marseille Cedex 07, France. Electronic address: lssylvia@yahoo.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Soare
authors.affiliation: Service de chirurgie maxillo-faciale, Hôpital Nord, chemin des Bourrely, 13015, Marseille, France; Aix-Marseille Université, Jardin du Pharo - 58, bd Charles Livon, 13284, Marseille Cedex 07, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Foletti
authors.affiliation: Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264 rue St Pierre, 13385, Marseille, France; Aix-Marseille Université, Jardin du Pharo - 58, bd Charles Livon, 13284, Marseille Cedex 07, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Gallucci
authors.affiliation: Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264 rue St Pierre, 13385, Marseille, France; Aix-Marseille Université, Jardin du Pharo - 58, bd Charles Livon, 13284, Marseille Cedex 07, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Collet
authors.affiliation: Service de chirurgie maxillo-faciale, Hôpital Nord, chemin des Bourrely, 13015, Marseille, France; Aix-Marseille Université, Jardin du Pharo - 58, bd Charles Livon, 13284, Marseille Cedex 07, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Guyot
authors.affiliation: Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264 rue St Pierre, 13385, Marseille, France; Aix-Marseille Université, Jardin du Pharo - 58, bd Charles Livon, 13284, Marseille Cedex 07, France; Laboratoire Parole et Langage (LPL), UMR 6057, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Chossegros
mesh_terms: D001766:Blindness / Q000209:etiology / Q000601:surgery*; D003161:Compartment Syndromes / Q000209:etiology; D006259:Craniocerebral Trauma / Q000150:complications*; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D009915:Orbit / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology
keywords: Orbital compression syndrome; Orbital decompression; Trauma