Safety and efficacy of bilateral same-day optic nerve sheath fenestration.

Document Type

Article

Publication Date

5-5-2026

Publication Title

Orbit (Amsterdam, Netherlands)

Abstract

PURPOSE: To evaluate the safety and efficacy of bilateral same-day optic nerve sheath fenestration (ONSF) in patients with vision-threatening papilledema.

METHODS: This multi-institutional study included 119 patients with bilateral papilledema who underwent same-day bilateral ONSF. Clinical data collected included: visual acuity (VA), visual field mean deviation (MD) and index (VFI), retinal nerve fiber layer (RNFL) thickness, and intraocular pressure (IOP). Pre- and postoperative outcomes and complications were evaluated with a Generalized Estimating Equation (GEE) using Statistical Analysis System (SAS) for analysis.

RESULTS: This cohort included 119 patients (87% female, mean age 43 years), with idiopathic intracranial hypertension (75%) as the most common cause of papilledema. The median follow-up was 12.5 months. Approximately 20% (40/198) of eyes had improvements in visual acuity >2 Snellen lines, 58% (114/198) had no change in vision, and 22% (44/198) had a decrease in vision >2 lines following ONSF. Visual field MD improved from -17.2 dB to -14.3 dB (

CONCLUSIONS: Same-day bilateral ONSF is a safe and effective option for patients with bilateral vision-threatening papilledema, demonstrating improvement in RNFL thickness while minimizing surgical risk and treatment delays.

First Page

1

Last Page

6

DOI

10.1080/01676830.2026.2663899

ISSN

1744-5108

PubMed ID

42084220

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