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Year : 2021  |  Volume : 1  |  Issue : 2  |  Page : 383-385

Ophthalmic artery occlusion due to orbital compartment syndrome after a frontotemporal craniotomy

1 Department of Ophthalmology, New York University, New York, NY, USA
2 Department of Ophthalmology, New York University; Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, Northwell Health, New York, NY, USA
3 Department of Ophthalmology, New York University; Department of Ophthalmology, Columbia University, New York, NY, USA

Correspondence Address:
Dr. Lauren DeMaria
New York University, 222 East 41st Street, 3rd Floor, New York, NY - 10017
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_1982_20

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A 32-year-old female with a right frontal lobe glioma underwent an elective frontotemporal craniotomy. One hour postoperatively, the patient developed a right orbital compartment syndrome (OCS) with unilateral acute vision loss, proptosis, afferent pupillary defect, and complete ophthalmoplegia. The patient underwent emergent lateral canthotomy and inferior cantholysis. Neuroimaging revealed extensive vascular congestion along the extraocular muscles at the orbital apex. Retinal imaging demonstrated an ophthalmic artery occlusion. OCS following a frontal or frontotemporal craniotomy relates to increased orbital venous congestion from direct compression of the myocutaneous flap and subsequent intraorbital pressure elevation, vascular compromise, and ocular ischemia.

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