Pediatric orbitotomies often lead to complications

DOHA, Qatar — The potential benefits gained by surgical removal of a space-occupying lesion from the orbit in pediatric patients may justify the risks of complications associated with the procedures, according to a recent retrospective study.

Mahmoud Salem, MD, FRCS, FRCOphth, and colleagues studied 30 children under 13 years of age who underwent 33 orbitotomies for space-occupying lesions of the orbit or orbital decompression. The complication rate for anterior orbitotomies was 20%. Primary lateral orbitotomies had a complication rate of 40%. Secondary orbitotomies produced complications 100% of the time, although only three patients underwent a secondary orbitotomy.

The most frequently encountered complications in lateral orbitotomies were abduction deficit and internal ophthalmoplegia. However, the procedure is safe if the goal is excisional biopsy and not en bloc removal of a mass, Dr. Salem advised.

Recurrence was one of the main surgical problems encountered in this series.

Two significant risk factors were identified: lesion or tumor location and the need for secondary radical procedures.

The study was published in the November/December issue of the Journal of Pediatric Ophthalmology & Strabismus.