Abstract
BackgroundIncreased use of the transorbital approach (TOA) warrants greater understanding of the risk of increased intraocular pressure (IOP) and intraorbital pressure (IORP) due to orbital compression. We aimed to investigate the changes in IOP and IORP in response to orbital retraction in TOA and establish a method for the continuous measurement of intraoperative IORP.MethodsWe assessed nine patients who underwent TOA surgery from January 2017 to December 2019, in addition to five cadavers. IORP and IOP were measured using a cannula needle monitor, tonometer, cuff manometer, and micro strain gauge monitor.ResultsIn all nine clinical cases and five cadavers, increased physical compression of the orbit increased the IOP and IORP in a curvilinear pattern. In clinical cases, when the orbit was compressed 1.5 cm from the lateral margin in the sagittal plane, the mean IOP and IORP were 25.4 ± 5.2 mmHg and 14 ± 9.2 mmH2O, respectively. The IORP satisfactorily reflected the IOP (Pearson correlation coefficient = 0.824, p < 0.001).ConclusionWe measured IOP and IORP simultaneously during orbital compression to gain basic information on pressure changes. In clinical cases, the change in the IOP could be conveniently and noninvasively monitored using continuous IORP measurements.
Highlights
Increased use of the transorbital approach (TOA) warrants greater understanding of the risk of increased intraocular pressure (IOP) and intraorbital pressure (IORP) due to orbital compression
To date, the TOA has been applied in a limited number of clinical cases, and little is known about its side effects
We investigated the changes in the IOP and IORP in TOA surgery
Summary
Increased use of the transorbital approach (TOA) warrants greater understanding of the risk of increased intraocular pressure (IOP) and intraorbital pressure (IORP) due to orbital compression. Recent studies have focused on the transorbital approach (TOA) as a minimally invasive approach for skull base lesions in the frontal and middle cranial fossa. Many intraorbital complications may arise from direct injury during surgery Several factors, such as direct cranial nerve injury or extraocular muscle injury due to surgery, may contribute to ocular abnormalities [3]. These complications can occur when the intraocular pressure (IOP) and intraorbital pressure (IORP) increase due to the increased physical traction by retraction of the orbit and venous
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