Hsu Cherng-Ru, Lee Lung-Chi, Chen Yi-Hao, Chien Ke-Hung
Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
Department of Medical Science, Graduate School, National Defense Medical Center, Taipei 11490, Taiwan.
J Pers Med. 2022 Apr 22;12(5):671. doi: 10.3390/jpm12050671.
Purpose: Orbital floor fractures commonly occur during orbital trauma. Currently, the indications for orbital fracture repair and the appropriate duration between trauma and surgical intervention remain controversial. Methods: Eyes diagnosed with orbital floor fractures that underwent reconstruction surgery were retrospectively reviewed. Demographic data were analyzed. Patients were classified based on the timing of the surgical intervention after injury. Ocular limitation and diplopia were evaluated preoperatively and postoperatively at one week, one month, and three months. Results: Two hundred seventy eyes of 270 patients (174 males and 96 females, mean age: 40.9 ± 16.3 years) were identified. The mean duration from injury to surgical intervention was 18.0 ± 21.2 days (range: 0−117 days). In the subgroup analysis, compared to delayed treatment, the early repair of floor fractures, i.e., within 7 days, was associated with significant motility and diplopia resolution at one week (p = 0.001, p < 0.001), one month (p < 0.001, p < 0.001), and three months (p < 0.001, p < 0.001). Sex and the duration from injury to repair were significantly associated with postoperative ocular motility (p = 0.001; p = 0.024) and diplopia (p < 0.001; p = 0.008) at three months. Multivariate analysis revealed that preoperative limitation and diplopia were correlated with postoperative limitation (p = 0.007) and diplopia (p = 0.001), respectively. Conclusions: The duration between orbital floor fracture and surgical treatment was associated with postoperative limitation and diplopia. Our results suggest that earlier intervention in symptomatic patients with orbital trauma may improve postoperative visual function.
眶底骨折常发生于眼眶外伤时。目前，眶骨折修复的指征以及外伤与手术干预之间的合适时间间隔仍存在争议。方法：对诊断为眶底骨折并接受重建手术的眼睛进行回顾性分析。分析人口统计学数据。根据受伤后手术干预的时间对患者进行分类。在术前以及术后1周、1个月和3个月评估眼球运动受限和复视情况。结果：共纳入270例患者的270只眼（男性174例，女性96例，平均年龄：40.9±16.3岁）。受伤至手术干预的平均时间为18.0±21.2天（范围：0 - 117天）。在亚组分析中，与延迟治疗相比，眶底骨折早期修复（即7天内）与术后1周（p = 0.001，p < 0.001）、1个月（p < 0.001，p < 0.001）和3个月（p < 0.001，p < 0.001）时显著的眼球运动恢复和复视缓解相关。性别以及受伤至修复的时间与术后3个月时的眼球运动（p = 0.001；p = 0.024）和复视（p < 0.001；p = 0.008）显著相关。多因素分析显示，术前眼球运动受限和复视分别与术后眼球运动受限（p = 0.007）和复视（p =
