Delayed Retrobulbar Hemorrhage after Orbital Floor Reconstruction.

Lee, Seung Woo; Choi, Young Woong; Nam, Sang Hyun; Kim, Hoon

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(4):489-491.
Published online July 1, 2010.

Delayed Retrobulbar Hemorrhage after Orbital Floor Reconstruction.

Seung Woo Lee, Young Woong Choi, Sang Hyun Nam, Hoon Kim

Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. pshero2@naver.com

Abstract

PURPOSE
Retrobulbar hemorrhage is a rare complication followed by blepharoplasty, trauma, orbital reconstruction, and so on. Most of the cases occur within 24 hours, half of them in the first 6 hours. Some authors have reported delayed retrobulbar hemorrhage after blepharoplasty and trauma within 1 day to 9 days. However, there have been few reports of delayed retrobulbar hemorrhage resulting from the complication of orbital reconstruction. METHODS: A 22-year-old male underwent orbital floor reconstruction due to the orbital floor fracture. In 84 hours after the surgery, he complained sudden onset orbital pain and decreased visual acuity immediately after defecation. Intraocular pressure was unmeasurable due to the swelling at that time. Emergency computed tomography was performed.
RESULTS
Computed tomography revealed subperiosteal hematoma on inferior orbital wall extended to the apex. Emergency decompressive surgery was performed within 1 hour. After evacuation of hematoma, orbital symptom was improved and visual acuity was restored.
CONCLUSION
Delayed retrobulbar hemorrhage is rare but vision-threatening.Therefore early diagnosis and treatment of delayed retrobulbar hemorrhage is thought to be crucial. The cause of delayed hemorrhage was not clear, however, valsalva maneuver might be the cause of hemorrhage.

Keywords: Delayed retrobulbar hemorrhage; Orbital floor fracture