Long term surgical outcomes of orbital cavernous haemangiomas (low-flow venous malformations) as performed in a tertiary eye hospital in China

Abstract

ObjectiveTo assess the long term efficacy and safety of surgical management of orbital cavernous haemangiomas (OCH) as performed in a tertiary eye hospital in China. MethodsA retrospective study with 74 OCH patients treated in the Eye Hospital, at the Zhongshan Ophthalmic Center, of Sun Yat-Sen University was performed covering a period from January 2002 to April 2010. The surgical approach, treatment results and visual outcome were recorded and analysed. ResultsSurgery was performed in all 74 patients and all tumours were completely removed. Among them, 93% of the cases (69/74) underwent anterior orbitotomy, with 43% (30/69) by a cutaneous approach, 57% (39/69) by a conjunctival approach and only 7% of the cases (5/74) used a lateral orbitotomy. The mean follow-up time was 4.6 years (range 2.0 to 10.0 years). Visual acuity improved in 32.4% of cases and deteriorated in 8.2% of cases. No residual proptosis existed. A complicated permanent pupil change was present in three cases and only one case showed a permanent slight motility deficit. Two cases with multiple masses recurred at two years after the first surgery, but neither recurring as assessed at 2 and 5 years after the second surgery. ConclusionsMost OCHs can be removed by anterior orbitotomy, using either a cutaneous or conjunctival approach. Anterior orbitotomy is a safe, convenient and effective surgical approach for OCH.