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Optic canal wall decompression may cause optic nerve damage
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Performing transphenoidal medial wall decompression of the optic nerve canal can cause physical damage to the optic nerve, according to a study on cadaver eyes. "Any hypothetical value in dural-arachnoid sheath opening must be weighed against the potential for harm ... caused by the surgical intervention," the study authors said.
Cassandra B. Onofrey, MD, and colleagues performed a medial optic decompression on five optic canals obtained from donors within 12 hours of death. The researchers decompressed two canals under direct visualization and three using a transphenoidal endoscopic approach, according to the study.
After decompression, the researchers removed the optic canals, beginning at the annulus of Zinn and extending to the optic chiasm, for gross and histological examination.
"Microscopic examination of the intracanalicular portion of optic nerve revealed incision in an extraocular muscle at the annulus, incomplete bone removal, fraying of the dural sheath, incomplete dural/arachnoid release, and incision in the pia and optic nerve," the authors said.
This study is published in the July/August issue of Ophthalmic Plastic and Reconstructive Surgery.