Abstract
A 63-year-old man was admitted to our clinic due to progressive visual impairment. He had a history of cerebrovascular disease about one year before admission, which had almost recovered in 5 months. Visual inpairment was noted 3 months before admission. On admission, visual acuity was 2 feet F.C. on the left and 20/100 on the right. There was bitemporal hemianopsia with bilateral centrocecal scotomas. Pneumoencephalogram revealed empty sella and dilatation of the third ventricle. Unifrontal craniotomy was performed. The anterior part of intrasellar space was empty. There was no adhesion around the chiasma and optic nerves. The chiasma and optic nerves were slightly flattened and stretched downward. The lower part of the lamina terminalis was opened about 3 mm in diameter. Then chiasmapexy was performed using the temporal muscle and arona adhesive. Postoperatively, visual acuity improved: 20/200 on the left and 20/50 on the right. Ten months after the operation, visual acuity was 20/200 on the left and 20/30 on the right. Combination of chiasmapexy and opening of the lamina terminalis seemed to have been effective for visual disturbance in empty sella syndrome.
