J Korean Assoc Oral Maxillofac Surg.  2017 Feb;43(1):42-45. 10.5125/jkaoms.2017.43.1.42.

Chemosis as complication in transconjunctival approach for orbital trauma

• Olate S
• Palmieri C
• de Moraes

• KMID: 2385069
• DOI: http://doi.org/10.5125/jkaoms.2017.43.1.42

Abstract

The aim of this report was to discuss a complication resulting from a transconjunctival approach to treating an orbital fracture. A 30-year-old male patient presented with a fracture to the zygomatic orbital complex. He was treated with transconjunctival conventional surgical treatment. Two days after surgical treatment, the patient presented with secondary chemosis which was initially slight and then subsequently worsened. The clinical situation was managed with topical and systemic corticosteroids and resolved within one postoperative month. Two-year follow-up showed ptosis of the upper eyelid and limited infraversion in the affected eye. This unusual complication associated with an orbital trauma was resolved with minor functional alterations, although the consequences observed after 2 years were not completely satisfactory.

Keyword

Orbital fracture; Complications; Orbital approach

MeSH Terms

Adrenal Cortex Hormones
Adult
Eyelids
Follow-Up Studies
Humans
Male
Orbit*
Orbital Fractures
Adrenal Cortex Hormones

Figure

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  Fig. 1 Preoperative computed tomography showing an orbital fracture with compromised orbital rim and floor.

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  Fig. 2 Chemosis of the left orbit observed in supraversion accompanied by ptosis of the upper left eyelid.

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  Fig. 3 During forced movement of the upper eyelid, an extensive chemosis subsequent to the transconjunctival approach is observed in the left orbit.

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  Fig. 4 Condition after 1 month where total recovery from the chemosis can be seen.

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  Fig. 5 Clinical condition after 2 years of follow-up, showing symmetry and absence of enophthalmos, dystopia or diplopia.

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  Fig. 6 Clinical condition after 2 years showing infraversion, demonstrating limitation in movement of the upper eyelid and limited downward movement of the eyeball. No alterations were observed in visual acuity, and no corneal ulcer or other types of alterations were seen.

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