Mertz M
HNO. 1986 Jan;34(1):15-20.
Fractures of the midface combined with orbital injuries endanger vision, binocular vision, and the lacrimal system. The best results of primary surgical management are advised if the surgeon adheres to a strict time schedule. For example, a perforating injury of the eye must be diagnosed as early as possible, and be repaired immediately. Otherwise, all manipulations necessary for reconstruction of the bone and soft tissue of the face worsen the condition of the opened eyeball, including loss of its contents and function. On the other hand, competent repair of the lacrimal system may be done at the end of the operation, and management of disordered eye mobility as seen in the "blow-out" fracture may sometimes be postponed for days or even weeks. The optimal chronological order of diagnostic and surgical management as seen from the ophthalmologist's view is given in tables, and discussed in detail.
面中部骨折合并眼眶损伤会危及视力、双眼视觉和泪器系统。如果外科医生严格遵守时间安排，建议进行一期手术治疗以获得最佳效果。例如，眼部穿通伤必须尽早诊断并立即修复。否则，面部骨骼和软组织重建所需的所有操作都会使开放眼球的状况恶化，包括眼球内容物和功能丧失。另一方面，泪器系统的有效修复可在手术结束时进行，而“爆裂”骨折中出现的眼球运动障碍的处理有时可推迟数天甚至数周。从眼科医生的角度来看，诊断和手术治疗的最佳时间顺序列于表格中并进行了详细讨论。
