Preliminary observations of embolization treatment of orbital varices with Glubran 2 acrylic glue

Abstract

To evaluate the outcome of embolization via orbital surgical exposure for a series of orbital varices. This study is a retrospective review of 28 patients (28 eyes, 11 men, 17 women) which were diagnosed as orbital varix from March to December in 2007, in the Institute of Orbital Diseases. Patient's age ranged from 11 to 54 years old, mean 32 years old. Right orbit 18 cases, left orbit 10 cases. All patients is under general anesthesia, operative approach included lateral orbitotomy (9 cases), anterior orbitotomy (11 cases), transconjunctival (7 cases) and percutaneous puncture (1 case). During the operation, venous malformations were dilatated and punctured with an 20-gauge catheter needle, then injected into 33% Glubran 2 with several punctures with different orientations of the needle were required to reach the different lobules of the venous pouch. Proptosis, visual acuity and eye movement for pre- and post-treatment were observed. All the patients treated with 100% efficiency, in which 16 cases (57%) were complete resolution of the signs and symptoms, no proptosis with Valsalva and correct completely or partially enophthalmos, 12 cases (43%) marked resolution. Six patients partial resection as lesion was stiffen after glue injection, and can touch in anterior part of the orbit. Complications included the vision acuity loss (1 case), limitation of ocular movement (3 cases), and proptosis (2 cases). The embolization with Glubran 2 after direct surgical exposure is the safe and effective treatment for orbital varix and can correct some enophthalmos.