Ataullah S, Whitehouse R W, Stelmach M, Shah S, Leatherbarrow B
Manchester Royal Eye Hospital, UK.
Eye (Lond). 1999 Aug;13 ( Pt 4):541-4. doi: 10.1038/eye.1999.134.
Post-enucleation socket syndrome (PESS: deep upper lid sulcus, ptosis or upper lid retraction, enophthalmos and lower lid laxity) is a well-recognised complication of a volume-deficient anophthalmic socket. A patient requiring enucleation following severe ocular trauma may have an underlying orbital wall blow-out fracture which if overlooked can cause severe volume deficit with poor cosmesis and limited prosthesis motility.
To establish the prevalence of an undiagnosed blow-out fracture in patients with PESS and a history of relevant trauma.
Medical records and orbital computed tomography (CT) scans were reviewed for all patients presenting with PESS and a history of relevant trauma.
Undiagnosed blow-out fractures were found in 15 (33%) of 45 patients presenting between August 1993 and December 1996. These were significant enough to warrant surgical repair in 13 (29%) patients.
We suggest that any patient presenting with PESS and a history of relevant trauma should be considered to have an orbital wall blow-out fracture until proven otherwise by CT scanning of the orbit. Similarly any patient requiring enucleation following severe ocular trauma should undergo CT scanning to rule out a coexisting blow-out fracture which could be repaired at the time of enucleation.
眼球摘除术后眼窝综合征（PESS：上睑深沟、上睑下垂或上睑退缩、眼球内陷及下睑松弛）是公认的眼球缺失性无眼球眼窝的一种并发症。严重眼外伤后需要眼球摘除的患者可能存在潜在的眼眶壁爆裂性骨折，如果被忽视，可能导致严重的容积缺失，影响美观且义眼活动受限。
确定患有PESS且有相关外伤史的患者中未诊断出的爆裂性骨折的患病率。
回顾了所有患有PESS且有相关外伤史的患者的病历和眼眶计算机断层扫描（CT）图像。
在1993年8月至1996年12月期间就诊的45例患者中，有15例（33%）发现了未诊断出的爆裂性骨折。其中13例（29%）骨折严重程度足以需要手术修复。
我们建议，任何患有PESS且有相关外伤史的患者，在眼眶CT扫描排除之前，均应考虑存在眼眶壁爆裂性骨折。同样，任何严重眼外伤后需要眼球摘除的患者都应进行CT扫描，以排除可能在眼球摘除时同时修复的并存爆裂性骨折。
