Lateral Canthotomy with Cantholysis

The treatment of orbital compartment syndrome cause by a retrobulbar hematoma causing symptoms—namely decreased visual acuity, increased intraocular pressure, or proptosis, is a procedure known as a lateral canthotomy with cantholysis

The primary indications for the procedure are:

1) Intraocular pressure > 40 mmHg.

2) Decreased visual acuity.

3) Proptosis.

Secondary indications include an afferent pupillary defect, cherry red macula, ophthalmoplegia, and eye pain. 

The steps of this procedure are:

1) Inject anesthetic into the lateral canthus.

2) Clamp the lateral canthus with a hemostat for 1 minute to devascularize.

3) Cut the lateral canthus about 1-2 cm.

4) With iris scissors pointed perpendicular to the patient just inside the orbital rim, identity the inferior crus of the canthal ligament.

5) Cut the inferior crus.

6) Recheck pressure and only of still elevated, cut the superior crus. Confrim IOP < 40 mmHg.



the_resuscitationist @the_resuscitationist



#Lateral #Canthotomy #Cantholysis #clinical #video #procedure #ophthalmology