Lee Han Byul, Lee Soo Hyang
Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Arch Craniofac Surg. 2018 Dec;19(4):248-253. doi: 10.7181/acfs.2018.02096. Epub 2018 Dec 27.
The presence of enophthalmos is an important determinant in the decision of orbital wall fracture surgery. We proposed eyelid drooping as a new anthropometric diagnostic measure and analyzed whether eyelid drooping is associated with enophthalmos.
This retrospective study was performed from January 2014 to December 2016. A total of 75 patients with blowout fractures were studied. One experimenter measured the degree of enophthalmos using a Hertel exophthalmometer at 1 week after trauma and at 3 months after surgery. The height change of the upper eyelid was measured using the marginal reflex distance (MRD) on both sides, and the degree of eyelid drooping was calculated by comparing the two lengths. We analyzed statistically the correlation between enophthalmos and eyelid drooping.
We found a highly significant correlation between the degree of enophthalmos and the reduction rate of MRD (RRM, as an indicator of eyelid drooping) at 1 week after trauma (r = 0.845). Approximately 2.0 mm of enophthalmos was associated with a 30.8% reduction in MRD on the affected side as compared with the normal side. At 3 months after surgery, patients showed improved eyelid appearance, with a moderate association between enophthalmos and RRM.
We demonstrated that the degree of enophthalmos, measured using an exophthalmometer, is associated with a change in the height of the upper eyelid. Thus, upper eyelid drooping can be used as another indicator for orbital wall fracture surgery. Compared with conventional methods, measurements of eyelid drooping are easy to perform, offering a great advantage and understanding to the patient.
眼球内陷的存在是决定眼眶壁骨折手术的重要因素。我们提出上睑下垂作为一种新的人体测量诊断方法，并分析上睑下垂是否与眼球内陷相关。
本回顾性研究于2014年1月至2016年12月进行。共研究了75例爆裂性骨折患者。一名实验者在受伤后1周和手术后3个月使用Hertel眼球突出计测量眼球内陷程度。使用双侧的边缘反射距离（MRD）测量上睑高度变化，并通过比较两侧长度计算上睑下垂程度。我们对眼球内陷与上睑下垂之间的相关性进行了统计学分析。
我们发现受伤后1周时眼球内陷程度与MRD降低率（RRM，作为上睑下垂的指标）之间存在高度显著相关性（r = 0.845）。与正常侧相比，约2.0 mm的眼球内陷与患侧MRD降低30.8%相关。手术后3个月，患者的眼睑外观有所改善，眼球内陷与RRM之间存在中度相关性。
我们证明，使用眼球突出计测量的眼球内陷程度与上睑高度变化相关。因此，上睑下垂可作为眼眶壁骨折手术的另一个指标。与传统方法相比，测量上睑下垂易于操作，对患者具有很大优势且易于理解。
