Proptosis: Management Outcomes and Complications following Orbitotomy

Background: Proptosis is one of the difficult to manage clinical entity faced by surgeons in emergency. Objective: To determine visual analysis following orbitotomy and complications in proptosis patients. Methodology: Study Design: Quasi-experimental, st study. Study Settings and Duration: At the Ophthalmology Department, Jinnah Postgraduate Medical Center, Karachi, from 1 th April 2014 to 30 October 2015. Total 30 patients of all age groups with proptosis were included. Preoperative assessment of the proptosis and the visual defects was done. Depending upon the provisional diagnosis, different surgical approaches of orbitotomy were performed. The diagnosis was further confirmed by histopathology of the excision biopsy specimens. Improvement in the proptosis and visual outcomes after the surgery was evaluated. Complications after the removal of tumors were also noted. Results: Out of 30 patients of proptosis, 25 (83.33%) were found to have decreased visual acuity, 7 (23.33%) had diplopia, 6 (20%) suffered from pain and there was a complete loss of vision in 2 cases (6.66%). After the intervention the size of proptosis reduced in all cases (100%) and improvement in the visual acuity in 21 (70 %). Complications observed were: Lateral rectus muscle damage 2 (6.66%) bleeding 2(6.66%), corneal abrasions 1 (13.33%) recurrent lesions 2(6.66%), restricted eye movements 2 (6.66% ), diplopia 2 (6.66%) while keratitis, fibrosis and ptosis were all each observed in one patient (3.3%). Conclusion: Appropriate orbital surgery for proptosis provided a high degree of success, with a significant improvement of visual acuity. Moreover, life threatening conditions were eliminated,with fewer complications.