Tuesday, February 26, 2008

Orbital cellulitis after faden operation on the medial rectus

Orbital cellulitis after faden operation on the medial rectus

Strabismus. 2007 Oct-Dec

Armesto A, Ugrin MC.
Ophthalmology Department, Hospital Alemán, Buenos Aires, Argentina.

Keywords: Orbital cellulitis; strabismus surgery; ethmoid sinusitis; Faden operation; intravenous antibiotics

BACKGROUND: Orbital cellulitis after strabismus surgery is uncommon, may cause blindness and may lead to death. Very few cases have been described in detail due to the low incidence of this complication.

METHODS: We report the first case of orbital cellulitis following Faden operation on the medial rectus muscle. We believe that the infection was due to asymptomatic ethmoid sinusitis. Our case is compared with other cases previously reported.

RESULTS: A two-year-old boy was surgically treated for residual esotropia after two botulinum toxin A injections. Two days after surgery, signs of orbital cellulitis developed in his right orbit. CT-scan disclosed right ethmoid sinusitis that spread to the orbit after surgery. After intravenous antibiotic treatment, the infection resolved with full restoration of visual acuity and ocular motility.

CONCLUSION: Despite adequate measures to prevent infection, orbital cellulitis may complicate strabismus surgery. Patients must be instructed to recognize early symptoms of this severe infection and call the surgeon immediately. Diagnosis may be confirmed by CT-scanning of the orbits. Prompt treatment with intravenous antibiotics usually leads to full recovery.




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