Vision impairment uncommon after orbitotomy for intraconal tumours

Postoperative severe vision impairment (PSVI) is a relatively rare occurrence among patients with intraconal tumours, a recent study has found. PSVI risk factors include severe optic nerve displacement and intraoperative tight adhesion.

Researchers conducted a retrospective analysis of 165 patients (mean age 45.5±17.5 years, 46.1 percent men) who had undergone orbitotomy. Twelve patients were diagnosed with PSVI after the procedure, yielding an incidence rate of 7.3 percent. In comparison, three patients developed no light perception (NLP) after surgery, corresponding to a 1.8-percent incidence rate.

Orbital apex tumours were significantly more common in those with vs without PSVI (75.0 percent vs 15.7 percent; p<0.001), as were severe optic nerve displacement (75.0 percent vs 20.9 percent; p<0.001) and intraoperative tight adhesion (41.7 percent vs 4.6 percent; p=0.001).

Multivariate logistic regression analysis confirmed that having a tumour in the orbital apex was a significant risk factor for PSVI (odds ratio [OR], 4.912, 95 percent confidence interval [CI], 1.011–23.866; p=0.048). The same was true for severe optic nerve displacement (OR, 6.007, 95 percent CI, 1.184–30.473; p=0.03) and intraoperative tight adhesion (OR, 12.031, 95 percent CI, 2.282–63.441; p=0.003).

Study limitations included its small sample size, narrow coverage of orbital diseases, and having very few cases of endoscopic and transcranial surgical approaches, all possibly contributing to potential bias.

“Therefore, a larger number of patients, probably in a multicentre study, are needed to verify the findings,” researchers said.