Objective: To explore the effect of the surgical removal of orbital deep cavernous hemangioma following the concept of minimal surgical invasion. Methods: Retrospective case series study. Sixty-three cases with surgical removal of deep orbital cavernous hemangioma were collected in the Affiliated Eye Hospital of Nanchang University from May 2012 to August 2015. There were 29 males and 34 females. The age was from 17 to 69 years with mean age (45±11) years.The surgical methods the conjunctival approach orbital surgery, lateral orbital surgery, medial skin orbital surgery, lateral orbital conjunctiva conjunctival pathway and endoscopic nasal approach were chosen for different cases. The visual acuity, visual field and electrophysiological examination were analyzed before and after operation. Result: Sixty-three patients underwent complete surgically removal of the tumor. Among them, 32 cases were conducted by conjunctival approach, 24 cases had improved visual acuity, 5 cases had no change of visual acuity, 3 cases had decreased visual acuity. Seventeen cases performed with lateral open orbital surgery had improved visual acuity in 11 cases, no change in visual acuity in 3 cases and decreased visual acuity in 3 cases postoperatively. Six cases with approach of the medial orbital surgery had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Six cases with approach of outside open orbital surgery combined with medial conjunctival pathway had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Two cases performed with endoscopic nasal approach. One of them had normal visual function and no change after surgery. Another had impaired visual function pre-operatively and it came back to normal postoperatively. Conclusions: With the concept of minimal surgical invasion, the choice of appropriate surgical approach can save patients with the greatest degree of visual function and even improve the visual function of the patients with orbital cavernous hemangioma. (Chin J Ophthalmol, 2017, 53: 288-293).
目的： 探讨微创理念指导下不同手术方法摘除眼眶深部海绵状血管瘤的手术效果。 方法： 回顾性系列病例研究。收集南昌大学附属眼科医院自2012年5月至2015年8月共63例经手术摘除的眼眶深部海绵状血管瘤患者的临床资料，其中男性29例，女性34例，年龄17~69岁，平均年龄（45±11）岁。分别采取经结膜入路开眶术、外侧开眶术、内侧皮肤开眶术、外侧开眶联合内侧结膜径路及鼻内镜下经鼻径路开眶术。分析患者手术前后的视力、视野及电生理检查结果。 结果： 63例患者均经手术完整摘除肿瘤，其中行经结膜入路开眶术32例，术后视力提高24例，视力无变化5例，视力下降3例；行外侧开眶术17例，术后视力提高11例，视力无变化3例，视力下降3例；行内侧皮肤开眶术6例，术后视力提高4例，视力不变1例，视力下降1例；行外侧开眶联合内侧结膜径路6例，术后视力提高4例，视力不变1例，视力下降1例；行鼻内镜下经鼻径路2例，1例术前未出现视功能损伤，术后视功能完全正常，1例术前出现视功能损伤，术后视功能完全恢复正常。所有患者均未出现视力丧失，视野及电生理检查完全正常。 结论： 在微创理念指导下，选择合适的手术方法可成功摘除眼眶海绵状血管瘤，并最大限度保存患者视功能甚至改善视功能。（中华眼科杂志，2017，53：288-293）.
Keywords: Hemangioma, cavernous; Orbital neoplasms; Surgical procedures, elective; Surgical procedures, minimally invasive.