Indian Journal of Plastic Surgery
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 CASE REPORT
Year : 2015  |  Volume : 48  |  Issue : 3  |  Page : 297--300

A report of 2 patients with transient blindness following Le Fort I osteotomy and a review of past reported cases


Department of Plastic Surgery and Burns, The Charles Pinto Centre for Cleft Lip, Palate and Craniofacial Anomalies, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India

Correspondence Address:
Philip Mathew
Jubilee Mission Medical College and Research Institute, Thrissur, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-0358.173129

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Blindness following a LeFort I osteotomy is a rare but extremely serious complication. Ten cases have been reported to date. None of these patients recovered vision. Optic neuropathy is believed to be the cause but the exact mechanism has not been settled. We report the first, and the only two, documented cases of complete loss of vision that recovered subsequently. The first patient was a 19-year-old male with repaired bilateral cleft lip and palate. He developed loss of vision in the right eye on the second postoperative day. The second patient was a 22-year-old male with repaired unilateral cleft lip and palate. He developed complete loss of vision in the left eye on the day of surgery. Both these patients underwent ongoing studies, which did not show any abnormalities. Both were treated with methylprednisolone. Both the patients gradually showed improvement in their vision. The first patient recovered normal vision several months postoperatively. The second patient's vision improved to 4/60 by 4 months postoperatively. We discuss the probable mechanisms of optic nerve injury and also the possible reasons why sight was restored in these patients. This is a rare but serious complication following a fairly common procedure. Through this article we wish to create an awareness of this complication and also a possible way of avoiding such a disaster.






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