Lateral canthotomy

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  • Lateral canthotomy and cantholysis is an emergency surgical procedure performed to relieve elevated intraorbital pressure caused by retrobulbar hemorrhage/orbital compartment syndrome (OCS)
  • Timely intervention can be vision-saving and is a critical skill for maxillo-facial surgeons

Decision Making[edit | edit source]

Lateral canthotomy and cantholysis should be performed immediately if a patient presents with signs of OCS, which include:

  • Acute vision loss or reduced visual acuity
  • Afferent pupillary defect (RAPD)
  • Proptosis
  • Tense, "rock-hard" eyelids
  • Elevated intraocular pressure (≥30 mmHg)
  • Painful ophthalmoplegia or restricted extraocular movements

If clinical findings strongly suggest OCS, do not delay the procedure for imaging nor for ophthalmology review

Surgical Anatomy[edit | edit source]

Pre-operative Planning[edit | edit source]

Consent[edit | edit source]

Risks[edit | edit source]

Alternatives[edit | edit source]

Surgical Instruments[edit | edit source]

Anaesthesia, positioning and draping[edit | edit source]

Skin Marking[edit | edit source]

Surgical Steps[edit | edit source]

Post-operative care[edit | edit source]

Follow-up[edit | edit source]

Complications[edit | edit source]

References[edit | edit source]

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