Purpose: To report a case of unilateral blindness after ipsilateral prophylactic transcranial optic canal decompression for fibrous dysplasia.
Methods: Case report. A 37-year-old woman with fibrous dysplasia underwent a prophylactic left optic canal decompression. Preoperatively, the left eye had a visual acuity of 20/20.
Results: Four days after apparently uncomplicated left optic canal decompression, the left eye lost all light perception. Blindness in the left eye persisted despite surgical exploration and transcranial optic nerve sheath fenestration.
Conclusion: Although prophylactic optic canal decompression warrants consideration in selected patients with fibrous dysplasia, notable risks are associated with this surgery.