Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang-si, South Korea.
J Craniofac Surg. 2022 Jun 1;33(4):1147-1149. doi: 10.1097/SCS.0000000000008314. Epub 2021 Oct 27.
To determine factors influencing postoperative enophthalmos after reconstruction of orbital wall fracture.
Data of consecutive patients who were diagnosed with unilateral medial or inferior orbital wall fracture from March 2013 to February 2020 were retrospectively reviewed. Forty-three patients were included in this study (24 with medial orbital wall fracture and 19 with inferior orbital wall fracture). Their medical records including Hertel exophthalmometry, preoperative computed tomography (CT) scan, and postoperative CT scan were reviewed. The degree of enophthalmos developed was calculated by measuring exophthalmos before surgery and at 6 months after surgery. Patients were classified into 2 groups depending on whether reduction was good after surgery or not. Data (eg, age, gender, onset, fracture size, and so on) were then compared between these 2 groups.
A total of 43 patients were included in the study. Their mean age was 40.1 years. There were 34 (79.1%) males. The mean onset from trauma to surgery was 8.1 days. Insufficient soft tissue reduction was found in 9 patients through postoperative CT scan. Preoperative mean enophthalmos was - 1.70 mm. Postoperative mean enophthalmos was -0.45 mm after 6 months. The mean fracture size was 213.74 mm2. There was no statistically significant difference in enophthalmos at 6 months after surgery regardless whether the reduction was good or not. Enophthalmos at 6 months after surgery was associated with preoperative fracture size and onset.
Postoperative enophthalmos development might be associated with preoperative fracture size and onset. Delayed operation in case of large orbital wall fracture might lead to undesired result. Thus, surgeons should keep that in mind.
确定影响眼眶壁骨折重建术后眼球内陷的因素。
回顾性分析 2013 年 3 月至 2020 年 2 月连续诊断为单侧内侧或下眼眶壁骨折的患者数据。本研究纳入 43 例患者（24 例内侧眼眶壁骨折，19 例下眼眶壁骨折）。查阅他们的病历，包括 Hertel 突眼度测量仪、术前计算机断层扫描（CT）和术后 CT。通过测量术前和术后 6 个月的突眼度来计算眼球内陷的程度。根据术后复位是否良好将患者分为两组。然后比较两组之间的数据（如年龄、性别、发病时间、骨折大小等）。
共纳入 43 例患者。他们的平均年龄为 40.1 岁。男性 34 例（79.1%）。从创伤到手术的平均发病时间为 8.1 天。术后 CT 扫描发现 9 例软组织复位不足。术前平均眼球内陷为-1.70mm。术后 6 个月平均眼球内陷为-0.45mm。平均骨折大小为 213.74mm²。无论复位是否良好，术后 6 个月的眼球内陷差异均无统计学意义。术后 6 个月的眼球内陷与术前骨折大小和发病时间有关。
术后眼球内陷的发展可能与术前骨折大小和发病时间有关。对于大眼眶壁骨折，延迟手术可能导致不理想的结果。因此，外科医生应该牢记这一点。
