Fan Xianqun, Li Jin, Zhu Jie, Li Haisheng, Zhang Disheng
Department of Ophthalmology, Ninth People's Hospital, Shanghai Second Medical University, Shanghai, Peoples Republic of China.
Ophthalmic Plast Reconstr Surg. 2003 May;19(3):207-11. doi: 10.1097/01.iop.0000062848.26273.e5.
To evaluate the use of computer-assisted volumetric measurement for the prediction of late enophthalmos and for volume estimation of implant material in the correction of late enophthalmos secondary to orbital blowout fractures (BOF).
This is a prospective observational study of 16 patients. Computer-assisted orbital volume measurements were made with the use of axial CT scans. Hertel exophthalmometry was used for the measurement of enophthalmos. The Lancaster test was used for measurement of diplopia. Autogenous bone or hydroxyapatite composite material was used for the repair of orbital defects and the correction of orbital volume expansion in 16 patients with enophthalmos caused by BOF. The volume of implant material was calculated from the orbital volume increment. Patients were followed for an average of 8 months after surgery.
There is a high correlation between the increment of orbital volume and the degree of enophthalmos; 1 cm3 orbital volume increment causes 0.89 mm of enophthalmos. Before surgery, 10 of the 16 patients had moderate enophthalmos (3 to 4 mm) and 6 patients had severe enophthalmos (> or = 5 mm). Six months after surgical intervention, 13 patients (81%) achieved satisfactory results; 3 patients had no enophthalmos and 10 had mild enophthalmos (1 to 2 mm). Three patients had moderate to severe enophthalmos.
The measurement of orbital volume in patients with BOF can be used to predict the degree of late enophthalmos. Use of the orbital volume increment to determine the amount of implant material can improve the therapeutic outcome in the correction of late enophthalmos caused by BOF.
评估计算机辅助容积测量在预测晚期眼球内陷以及眼眶爆裂性骨折（BOF）继发晚期眼球内陷矫正中植入材料体积估计方面的应用。
这是一项对16例患者的前瞻性观察研究。使用轴向CT扫描进行计算机辅助眼眶容积测量。采用Hertel眼球突出计测量眼球内陷。使用Lancaster试验测量复视。16例因BOF导致眼球内陷的患者采用自体骨或羟基磷灰石复合材料修复眼眶缺损并矫正眼眶容积扩大。根据眼眶容积增量计算植入材料的体积。患者术后平均随访8个月。
眼眶容积增量与眼球内陷程度之间存在高度相关性；眼眶容积每增加1 cm³会导致眼球内陷0.89 mm。术前，16例患者中有10例为中度眼球内陷（3至4 mm），6例为重度眼球内陷（≥5 mm）。手术干预6个月后，13例患者（81%）取得满意效果；3例患者无眼球内陷，10例有轻度眼球内陷（1至2 mm）。3例患者有中度至重度眼球内陷。
BOF患者的眼眶容积测量可用于预测晚期眼球内陷程度。利用眼眶容积增量确定植入材料的量可改善BOF继发晚期眼球内陷矫正的治疗效果。
