Metal Mouth Message Board

Hi

Well I am about to have bimax surgery high le fort 1 and lower jaw also and have come across some disturbing articles on blindness and high le fort 1. I am literally freaking out right now.
Do people get completely blind or what when high le fort 1 is performed??? jesus, i do not know what to do. Do you lose sight only on one eye? I can't believe i am even asking this.

[quote="Mandy22"]Hi

Well I am about to have bimax surgery high le fort 1 and lower jaw also and have come across some disturbing articles on blindness and high le fort 1. I am literally freaking out right now.
Do people get completely blind or what when high le fort 1 is performed??? jesus, i do not know what to do. Do you lose sight only on one eye? I can't believe i am even asking this.[/quote]


I mean i am doing this because i do not like what i see in the mirror. But still OMG i am really scared right now. Should i have le fort 2 instead??

lefort 1/2/3/4 doesn't make a difference. it's just the number of pieces cut. not sure how blindness can result from jaw surgery. i know they sow your eyes such during surgery.

Blindness as a complication of Le Fort I osteotomy for maxillary distraction.
Lo LJ, Hung KF, Chen YR.
Source

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Abstract

High Le Fort I osteotomy and maxillary distraction has become an accepted method for the treatment of maxillary retrusion in children and teenagers with cleft lip and palate or craniofacial anomalies. This procedure effectively corrects the dentofacial deformity in these patients. No major surgical morbidity has been reported. During the past 4 years, 94 cleft patients with maxillary hypoplasia received Le Fort I osteotomy and distraction osteogenesis at the authors' center. Two of them developed blindness after this operation. The first case was a girl with bilateral cleft lip and palate with median facial dysplasia. She received high Le Fort I osteotomy at age 12 years 4 months to correct maxillary retrusion. Right eye swelling and ecchymosis was found after surgery. The patient complained of vision loss in that eye 2 days later. Computed tomography showed subarachnoid hemorrhage and skull base hematoma. There were no atypical fractures in the orbit, pterygoid plates, sphenoid bone, and skull base. Angiogram revealed left ophthalmic and basilar artery aneurysm. The second case was a 12-year-old boy with left cleft lip and palate. He received Le Fort I osteotomy to correct maxillary retrusion. During surgery, abnormal pupil dilatation was found after the osteotomy and down-fracture of maxilla. Emergent computed tomography found no hemorrhage or atypical fractures. Examination revealed complete left optic neuropathy and partial right abducens nerve palsy with mydriasis. Magnetic resonance imaging, magnetic resonance angiography, and repeated computed tomography revealed no sign of orbital injury, vascular problem, or abnormal fractures. The cause of blindness was unknown. In both cases, a steroid was used. Maxillary distraction was continued. Recovery of meaningful visual sense did not occur after 3 and 2 years' follow-up, respectively. A review of the literature revealed five other patients who suffered from visual loss after Le Fort I osteotomy. Inadvertent skull base fractures were identified in two cases, but a cause for the blindness was not known in the others. Induced hypotension and indirect trauma may be responsible for the optic nerve injury. In none of the cases was meaningful visual sense recovered, although high-dose steroids were given. In conclusion, a total of seven cases developed blindness after Le Fort I osteotomy. Once blindness develops, the prognosis is poor. High Le Fort I osteotomy should be performed with extreme care, and perhaps the informed consent should include visual loss as a complication of the procedure.

It's not conventional le fort 1. The cut is made higher than conventional le fort 1.

it does seem to be a real risk. do you have a cleft lip/palate or craniofacial anomoly then? It looks like it was only one eye in each patient, and mostly unknown cause so difficult to predict.