July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
An analysis of postoperative visual field result of tailored anterior temporal lobectomy
Author Affiliations & Notes
  • WEI XIAO
    ZHONGSHAN OPTHALMIC CENTER, Guangzhou, China
  • Footnotes
    Commercial Relationships   WEI XIAO, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2300. doi:
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      WEI XIAO; An analysis of postoperative visual field result of tailored anterior temporal lobectomy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2300.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To analyze the cause of visual field defects after the tailored anterior temporal lobectomy in order to further reduce the incidence of visual field defect post-operatively.

Methods : 17 patients with temporal epilepsy treated by the tailored anterior temporal lobectomy were reviewed retrospectively. MRI brain before and after the operation were fused together using the navigation software (iPlan, BrainLab). For each case, two distances were measured: [1] the distance from the the temporal pole to the anterior limit of Meyer’s loop (TP-ML), [2] the distance from the temporal pole to the anterior limit of the resected temporal lobe (TP-TL) which represent the length of anterior temporal lobectomy. The two measures were compared in each case to see whether the visual field defect was related to direct injury to Myer’s loop or not.

Results : Of the 17 cases after modified anterior temporal lobectomy for epilepsy, 9 (53%) cases had no visual field defect and 8 (47%) patients had contralateral upper quadrant visual field defect. All TP-TL distance were shorter than TP-ML except three cases in whom the two distances were equal or almost equal. These three cases had visual field defect which could be a result of direct injury to the Meyer’s loop because the resection had reached the structure. In the remaining 5 cases with visual field defect, the anterior temporal lobectomy length was 20 to 45mm away from the anterior limit of the Meyer’s lobe and could not explain the occurrence of visual field defect.

Conclusions : Visual field defect can occur after tailored anterior temporal lobectomy without evidence of direct injury to the Meyer’s loop by the temporal resection. This is most likely due to retraction of the temporal lobe causing indirect injury to the Meyer’s loop. To further reduce the incidence of visual field defect, gentle handling of the temporal lobe should be addressed.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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