Factors Affecting Persistent Diplopia after Surgical Repair of Isolated Inferior Orbital Wall Fracture.

Kim, Joseph; Kang, Sung Mo

doi:2019.60.2.181

J Korean Ophthalmol Soc > Volume 60(2); 2019 > Article

Original Article

Journal of the Korean Ophthalmological Society 2019;60(2):181-186.
DOI: https://doi.org/10.3341/jkos.2019.60.2.181 Published online February 15, 2019.

Factors Affecting Persistent Diplopia after Surgical Repair of Isolated Inferior Orbital Wall Fracture.

Joseph Kim, Sung Mo Kang

Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea. ksm0724@inha.ac.kr

단독 안와하벽골절복원술 후 회복되지 않는 고착화된 복시와 관련된 인자

김요셉⋅강성모

인하대학교 의과대학 안과학교실

Correspondence: Sung Mo Kang,
Email: ksm0724@inha.ac.kr

Received: 2 August 2018 • Revised: 29 September 2018 • Accepted: 19 January 2019

Abstract

PURPOSE
To investigate factors affecting persistent diplopia after surgical repair of isolated inferior orbital wall fractures. METHODS: Thirty-three patients who underwent surgical repair of isolated inferior orbital wall fractures in Inha University Hospital Ophthalmology Department from 2014 to 2017 were enrolled in this study. The authors examined facial computed tomography, diplopia, extraocular muscle movement, and Hertel's exophthalmometer before and 6 months after surgery. The diplopia which was not recovered even at 6 months postoperatively was defined as persistent diplopia. Multivariable logistic regression analyses were performed on parameters that were found to be related to persistent diplopia using univariable logistic regression analyses. RESULTS: Univariable regression analysis showed that preoperative ocular motility limitation, preoperative diplopia, the type of fracture, the number of contacts with the fracture site and extraocular muscle (EOM), and EOM tenting were associated with persistent postoperative diplopia. Multivariable regression analysis using the previously mentioned five parameters showed 28.3-fold and 17.4-fold greater probabilities of diplopia after surgery in preoperative diplopia and EOM tenting, respectively (p = 0.023). CONCLUSIONS: Preoperative diplopia and EOM tenting were associated with persistent postoperative diplopia. These parameters were predictors of persistent diplopia in eyes with isolated inferior orbital wall fractures.

Key Words: Isolated inferior orbital wall fracture;Postoperative diplopia;Surgical repair of orbital wall fracture