Long term surgical outcomes of orbital cavernous haemangiomas (low-flow venous malformations) as performed in a tertiary eye hospital in China

Abstract

Objective: To assess the long term efficacy and safety of surgical management of orbital cavernous haemangiomas (OCH) as performed in a tertiary eye hospital in China.

Methods: A retrospective study with 74 OCH patients treated in the Eye Hospital, at the Zhongshan Ophthalmic Center, of Sun Yat-Sen University was performed covering a period from January 2002 to April 2010. The surgical approach, treatment results and visual outcome were recorded and analysed.

Results: Surgery was performed in all 74 patients and all tumours were completely removed. Among them, 93% of the cases (69/74) underwent anterior orbitotomy, with 43% (30/69) by a cutaneous approach, 57% (39/69) by a conjunctival approach and only 7% of the cases (5/74) used a lateral orbitotomy. The mean follow-up time was 4.6 years (range 2.0 to 10.0 years). Visual acuity improved in 32.4% of cases and deteriorated in 8.2% of cases. No residual proptosis existed. A complicated permanent pupil change was present in three cases and only one case showed a permanent slight motility deficit. Two cases with multiple masses recurred at two years after the first surgery, but neither recurring as assessed at 2 and 5 years after the second surgery.

Conclusions: Most OCHs can be removed by anterior orbitotomy, using either a cutaneous or conjunctival approach. Anterior orbitotomy is a safe, convenient and effective surgical approach for OCH.

Keywords: Anterior orbitotomy; Cavernous haemangiomas; Lateral orbitotomy; Orbital tumour; Surgery.