Lee Sang Hun, Lew Helen, Yun Young Soo
Department of Ophthalmology, College of Medicine Pochon CHA University, 351 Yatap-dong, Bundang-gu, Sungnam, Gyeonggi-do 463-712, Korea.
Yonsei Med J. 2005 Jun 30;46(3):359-67. doi: 10.3349/ymj.2005.46.3.359.
It is difficult to identify the exact cause of ocular motility disturbances in orbital wall fracture patients. By performing CT and ocular motility tests before and after surgery, this study analyzes the functions of the extraocular muscles and determines correlations between the results. Between February 2001 and January 2003, 45 eyes of 45 patients with orbital wall fractures, whose medical records could be traced back at least 6 months, underwent surgical repair in our hospital. All variables were analyzed using the independent t-test, paired t-test, and Chi-square test. There was no significant difference in the location and degree of fracture and the incarceration pattern of 6 patients who had moderate or severe diplopia, and of the remaining patients 6 months after surgery. However, in the case of diplopia, the sum of ocular motility limitation was 5.67 +/- 4.18, and the degree of extraocular motility disturbance was 3.67 +/- 2.42 before surgery. When there was no diplopia, the sum of ocular motility limitation was 1.13 +/- 1.38, and the degree of extraocular motility disturbance was 1.08 +/- 1.16 (p < 0.005, independent t-test). Ocular movement was successfully recovered by surgical reduction within 3 weeks from trauma. Postoperative ocular motility disturbance was more related to various ocular motility test results than CT findings. Ocular motility disturbances can remain after surgery if ocular motility limitation and extraocular motility disturbance are significant after trauma. Additional studies on the various tests to examine functions of extraocular muscles are required to identify and analyze the exact cause of ocular motility disturbance.
眼眶壁骨折患者眼球运动障碍的确切病因难以确定。本研究通过在手术前后进行CT和眼球运动测试，分析眼外肌的功能并确定结果之间的相关性。2001年2月至2003年1月期间，45例眼眶壁骨折患者的45只眼睛在我院接受了手术修复，这些患者的病历可追溯至少6个月。所有变量均采用独立t检验、配对t检验和卡方检验进行分析。6例有中度或重度复视的患者与其余患者在骨折部位和程度以及嵌顿模式方面在术后6个月时无显著差异。然而，在复视的情况下，术前眼球运动受限总和为5.67±4.18，眼外运动障碍程度为3.67±2.42。无复视时，眼球运动受限总和为1.13±1.38，眼外运动障碍程度为1.08±1.16（独立t检验，p<0.005）。外伤后3周内通过手术复位成功恢复了眼球运动。术后眼球运动障碍与各种眼球运动测试结果的相关性比与CT表现的相关性更大。如果外伤后眼球运动受限和眼外运动障碍明显，术后眼球运动障碍可能会持续存在。需要对各种检查眼外肌功能的测试进行更多研究，以确定和分析眼球运动障碍的确切病因。
