Orthognathic Surgery and Its Impact on Eye Pressure Concerns - Dentistry

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Orthognathic surgery, commonly referred to as jaw surgery, is a procedure designed to correct various dental and skeletal irregularities, including misalignment of the jaw and teeth. Your concerns regarding the impact of this surgery on eye pressure and potential risks to the optic nerve are valid, especially considering your history of high intraocular pressure (IOP) and previous laser eye surgery.

Firstly, it is important to understand that during orthognathic surgery, particularly procedures like the Le Fort I osteotomy, there is a risk of complications that can affect the surrounding structures, including the eyes and optic nerve. The use of low-pressure anesthesia during such surgeries is intended to minimize systemic complications, but it can raise concerns about blood flow to the optic nerve, especially in patients with pre-existing conditions like elevated eye pressure.

In your case, the concern arises from the potential for reduced blood flow to the optic nerve during surgery due to low-pressure anesthesia, combined with your elevated IOP. The optic nerve requires a consistent blood supply to function properly, and any compromise in this supply could theoretically lead to ischemia (lack of blood flow), which may result in visual disturbances or even permanent damage. However, it is essential to note that the risk of such complications is generally low, especially in a well-monitored surgical environment.

Regarding your previous laser eye surgery, it is crucial to inform your surgical team about your medical history, including any changes in your vision or eye pressure. This information will help them take necessary precautions to ensure your safety during the procedure. Typically, patients who have undergone laser eye surgery can still undergo orthognathic surgery, but the surgical team will need to evaluate your specific case, including your current eye pressure and overall eye health.

Moreover, the relationship between IOP and optic nerve health is complex. Elevated IOP is a significant risk factor for glaucoma, which can lead to optic nerve damage over time. If you have a history of high eye pressure, it is critical to manage this condition effectively before and after any surgical procedure. Your ophthalmologist may recommend a comprehensive eye examination and possibly adjust your glaucoma medications to ensure your IOP is well-controlled prior to surgery.

In summary, while orthognathic surgery can be performed on patients with a history of laser eye surgery and elevated IOP, it is vital to have a thorough preoperative assessment. Discuss your concerns with both your ophthalmologist and the oral surgeon performing the orthognathic procedure. They can collaborate to develop a tailored approach that minimizes risks and ensures optimal outcomes for both your dental and ocular health. Always prioritize open communication with your healthcare providers to address any concerns and ensure that all aspects of your health are considered during surgical planning.