[Treatment of orbital venous malformation using surgical procedure combined with Nd:YAG laser].

ABSTRACT

OBJECTIVE: To evaluate the security and efficacy of surgical procedure combined with NdYAG laser in the management of orbital venous malformation. METHODS: A total of 17 successive patients with orbital venous malformation were treated with surgical excision in conjunction with NdYAG laser from July 2003 to June 2005. General anesthesia was performed in all patients. Appropriate approach was used according to the location and size of the lesion as well as its relation with adjacent tissues. Surgical procedure and laser coagulation were performed alternatively. Intermittent or continuous photocoagulation aimed at minor and deep lesions or large and superficial lesions was administrated, respectively, when indicated. Laser power of these two procedures was set at 60 to 90 J/cm2 or less than 100 J/cm2, respectively. Cold saline solution was used to cool the targeted region immediately after photocoagulation in case of damage to surrounding normal tissues. RESULTS: Seventeen patients were followed-up for 12 to 26 months. Notable lesion regression was found in 15 cases and fair reduction of the lesion in 2 cases. Vision acuity decrease did not occur and vision acuity increase was found in 2 patients. Exophthalmos was completely corrected, enophthalmos was found in 4 patients, the movement of the eyeballs was markedly improved. Complications consisted of superior oblique muscle paralysis (1 case) and ptosis (1 case). Relapse or aggravation of residual lesion was not found during the whole follow-up period. CONCLUSIONS: Surgical procedure combined with NdYAG laser is a safe and effective procedure in managing patients with orbital venous malformation. Laser treatment can decrease the hemorrhage during operation, make the surgical procedure easier, reduce the risk of operation and improve the results of surgical treatment.