Abstract
Patients should be evaluated and deemed appropriate for such surgical intervention. Patients with orbital compartment syndrome due to hemorrhage, pneumo-orbita, or other causes of increased intraorbital pressure, who are at risk for optic nerve compression or hypoperfusion, are candidates for this procedure. Experimental studies demonstrate that permanent ischemic changes can occur within 90 min, so this procedure is performed emergently in appropriate patients, without waiting for radiographic studies. Additional therapeutic measures, such as the administration of ocular hypotensive drops or systemic osmotic diuretics, may also be indicated. The technique can also be utilized on an elective basis in conjunction with other procedures for horizontal lid tightening or reconstruction. Patients should be educated about the risks and benefits of the procedure, including alternatives.