Changes in Visual Field Defect : Post-Pituitary Tumor Resection Comparison Between Transphenoidal and Transcranial Approaches
Vol. 4 Issue 1 : 2016


To compare patients with pituitary adenoma who underwent transphenoidal (TS) and transcranial (TC) surgery, the visual outcome and postoperative complications. Retrospective analysis of case notes of 45 patients {(90 eyes) 14 TC, 31 TS} with pituitary adenoma who underwent pituitary tumour resection between 1998 and May 2002. The patients’ age ranged from 16 to 66 years with a mean ± SD of 41.7 ± 31.1 years. 56% are male. Fourteen patients were operated by TC. Preoperatively, visual acuity deficit occurred in 64% vs 96% (TS vs TC, p =0.011). Postoperatively, visual acuity (VA) returned to normal in 37.5% in TS and 22.2% in TC (p=0.186), improved in 30% in TS and 33.3% in TC (p=0.773), no change in 17.5% in TS and 29.6% in TC (p=0.243) and worsened in 15% in TS, 14.8% in TC (p=0.742). Visual field (VF) defect occurred in 54% vs 82% (TS vs TC, p=0.034) preoperatively. Postoperatively, VF returned to normal in 37.1% in TS, 21.7% in TC (p=0.215), improved in 17.2% in TS, 26.1% in TC (p=0.623), no change in 40% in TS, 39.2% in TC (p=0.947) and worsened in 5.7% in TS, 13.0% in TC (p=0.621). There was no significant difference in improvement of visual function between TS and TC, (VA, p=0.786 and VF, p=0.710). Complications were observed more in TS surgery. Visual function improves significantly after both techniques of surgery. However, there was no significant difference noted between the two techniques. TS had more visual improvement compared to TC. Complications were more in patients who had undergone transphenoidal surgery