J Korean Ophthalmol Soc > Volume 55(11); 2014 > Article
Journal of the Korean Ophthalmological Society 2014;55(11):1589-1594.
DOI: https://doi.org/10.3341/jkos.2014.55.11.1589    Published online November 15, 2014.
Outcomes of Isolated Medial Orbital Wall Fracture Reconstructions.
Jung Hee In, Sun Young Jang, Youn Joo Choi, Hye Sun Choi, Jae Woo Jang, Sung Joo Kim
1Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. ysyat01@naver.com
2Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
3Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea.
안와 내벽의 단독 외향 골절에서의 골절 정복의 수술적 결과
인정희1⋅장선영1⋅최연주2⋅최혜선3⋅장재우3⋅김성주3
Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine1, Bucheon, Korea
Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine2, Seoul, Korea
Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine3, Seoul, Korea
Abstract
PURPOSE
To evaluate surgical results after the reconstruction of isolated medial orbital wall fractures. METHODS: We performed a retrospective chart review of patients with isolated medial orbital wall fractures who underwent reconstruction using the transcaruncular approach from March 2012 to October 2013. Computed tomography (CT) was performed before and after surgery. Postoperative follow-ups were conducted at 1 week, 1 month, and 3 months. Diplopia, ocular motility, postoperative complication, and exophthalmometry were recorded at each follow-up visit. Preoperative and postoperative enophthalmos was quantified using Hertel exophthalmometry and a quantitative method for the area of the circular sector under the chord (CA)/orbital area (OA) ratio at the CT scan. Patients were divided into either the incomplete or complete reduction groups based on the degree of reduction observed on postoperative CT. RESULTS: We evaluated 55 patients (42 males, 13 females) with an average age of 36 years. Five of 55 patients with preoperative enophthalmos of more than 2 mm obtained good symmetry after surgery. Diplopia at primary gaze was resolved in 9 of 9 patients and 2 patients had residual diplopia on lateral gaze. The difference of exophthalmometry and CA-to OA ratio between before and after reconstruction was not significantly changed in either the incomplete or complete groups. CONCLUSIONS: Enophthalmos and diplopia were well corrected in all subjects. If reduction was successfully performed in the anterior portion of medial orbital wall fracture, clinically significant enophthalmos might be preventable even if complete reduction was not obtained.
Key Words: Enophthalmos;Isolated medial orbital wall fracture;Surgical outcome


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