OPTIC-NERVE SHEATH FENESTRATION FOR PROGRESSIVE ISCHEMIC OPTIC NEUROPATHY - RESULTS IN 2ND-SERIES CONSISTING OF 21 EYES

Objective: To determine the efficacy of optic nerve sheath fenestratio n in eyes with the progressive form of common anterior ischemic optic neuropathy. This investigation complements a previously reported initi al series of 26 similar patients. Patients and Methods: Optic nerve sh eath fenestrations were performed in 21 eyes for treatment of common ( nonarteritic) ischemic optic neuropathy with documented progressive de terioration of visual function. All patients underwent thorough preope rative and postoperative ocular evaluations by the Neuro-Ophthalmology Service at the Bascom Palmer Eye Institute, Miami, Fla. Results: Duri ng a mean follow-up of 22.5 weeks (range, 3 to 104 weeks), results wer e as follows: visual acuity increased by 2 or more lines on the Snelle n chart in two eyes (9.5%; the combined improvement rate for the two s eries was 14.9%); visual acuity decreased by 2 or more lines in two ey es (9.5%). Conclusions: Data from this series of 21 surgical procedure s indicate no beneficial effect on visual morbidity in cases of common ischemic optic neuropathy and confirm the generally poor visual outco me implied from the results of optic nerve sheath decompression in our initial series. Based on this experience with a total of 47 eyes, we have discontinued optic nerve sheath decompression as a form of therap y for ischemic optic neuropathy.