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July 2015

Enucleation as Endoscopic Sinus Surgery Complication

Author Affiliations
  • 1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Ophthalmol. 2015;133(7):850-852. doi:10.1001/jamaophthalmol.2015.0706

Functional endoscopic sinus surgery (FESS) is a commonly performed procedure that has a risk of serious ophthalmic complications. We report a case of complete enucleation as a complication of FESS.

A 42-year-old man with sinonasal polyposis, nasal septal deviation, and no previous sinus surgery underwent septoplasty and endoscopic polypectomy (FESS) involving the maxillary and ethmoid sinuses. Prior to surgery, visual acuity was 20/20 OU without correction. The otolaryngology operative note described using a microdebrider to remove uncharacteristic-appearing polyps from what was thought to be the right maxillary sinus until right enophthalmos was noted and the operation was halted. The patient was then transferred from the outpatient surgery center to the emergency department for definitive ophthalmology evaluation and management.

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