Postoperative severe visual impairment: surgical outcome of 165 patients with orbital tumours in the muscle cone

Objective This study aimed to evaluate the risk factors of postoperative severe vision impairment (PSVI) for a primary orbital tumour in the muscle cone. Methods A retrospective analysis of the patients who underwent orbitotomy for primary intraconal tumours at the Tianjin Medical University Eye Hospital from January 2010 to December 2015. Results A total of 165 cases of orbitotomy for primary orbital tumours in the muscle cone were included in the study. Postoperatively, 12 cases with vision acuity ≤20/400 or ≥4 rows of vision decline and without any corrected effect were analysed as PSVI, including no light perception (NLP) for 3 cases. The multivariate logistic regression indicated that the tumour in orbital apex ( P = 0.048, OR = 4.912, 95% CI: 1.011–23.866), severe optic nerve displacement ( P = 0.030, OR = 6.007, 95% CI: 1.184–30.473) and intraoperative tight adhesion ( P = 0.003, OR = 12.031, 95% CI: 2.282–63.441) were the independent risk factors for PSVI. Conclusions The incidence of PSVI for the intraconal tumour was 7.3%, and the incidence of NLP was 1.8%. The tumour in orbital apex, severe optic nerve displacement and intraoperative tight adhesion were independent risk factors for PSVI.