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评估Medpor植入对眼眶壁骨折患者眼外肌功能、眼球运动障碍和复视的影响。

Evaluation of the effect of Medpor implantation on extraocular muscle function, eye movement disturbance and diplopia in patients with orbital wall fracture.

作者信息

Jin Tao, Zhang Lizhi, Zhao Yafang, Tong Chunmei, Yang Yang

机构信息

Department of Ophthalmology, Bethune International Peace Hospital Shijiazhuang 050082, Hebei, China.

出版信息

Am J Transl Res. 2024 Nov 15;16(11):7115-7125. doi: 10.62347/MIFA3686. eCollection 2024.

Abstract

OBJECTIVE

To evaluate the impact of Medpor implantation on extraocular muscle function, eye movement disorders, and diplopia in patients with orbital wall fracture.

METHODS

A retrospective study was conducted on 98 patients (98 eyes) who underwent Medpor implantation surgery at Bethune International Peace Hospital from January 2019 to December 2022. The degree of eyeball enophthalmos and total fracture area in patients before and after surgery, as well as orbital volume were measured. The relationship between enophthalmos severity and total fracture area was analyzed. Changes in extraocular muscle function, eye movement, and diplopia were assessed before and after surgery.

RESULTS

Before operation, enophthalmos severity was correlated with the total fracture area (r = 0.323, P = 0.001). After surgery, there was no significant correlation (r = -0.053, P = 0.630). Compared with preoperative measurements, both orbital volume and the volume difference improved significantly after surgery (both P < 0.05). Among the patients who received surgery within 3 weeks, the cure rates for rectus muscle restriction and extraocular muscle paralysis were 94.12% and 100.00%, respectively, higher than those in patients who underwent surgery after 3 weeks (67.27% and 65.62%) (P < 0.05). In comparison of preoperative conditions, notable improvements were observed in both ocular motility disorders and diplopia after operation (both P < 0.05). The total improvement rates in ocular motility disorders at 1, 3 and 6 months of follow-up were 84.69%, 90.82%, 96.94%, respectively, while these rates in diplopia were 89.79%, 91.84% and 95.92%, respectively. Abnormal maxillofacial sensations also improved significantly at 1-, 3-, and 6-month post-surgery (all P < 0.05).

CONCLUSIONS

Medpor implantation effectively restores extraocular muscle function in patients with orbital wall fractures, significantly alleviating diplopia, eye movement disorders, and maxillofacial abnormalities.

摘要

目的

评估Medpor植入术对眼眶壁骨折患者眼外肌功能、眼球运动障碍及复视的影响。

方法

对2019年1月至2022年12月在白求恩国际和平医院接受Medpor植入手术的98例患者(98只眼)进行回顾性研究。测量患者手术前后眼球内陷程度、骨折总面积及眼眶容积。分析眼球内陷严重程度与骨折总面积的关系。评估手术前后眼外肌功能、眼球运动及复视的变化。

结果

术前,眼球内陷严重程度与骨折总面积相关(r = 0.323,P = 0.001)。术后,两者无显著相关性(r = -0.053,P = 0.630)。与术前测量值相比,术后眼眶容积及容积差值均显著改善(均P < 0.05)。在3周内接受手术的患者中,直肌受限和眼外肌麻痹的治愈率分别为94.12%和100.00%,高于3周后接受手术的患者(67.27%和65.62%)(P < 0.05)。与术前情况相比,术后眼球运动障碍和复视均有明显改善(均P < 0.05)。随访1、3和6个月时,眼球运动障碍的总改善率分别为84.69%、90.82%、96.94%,而复视的改善率分别为89.79%、91.84%和95.92%。术后1、3和6个月时,颌面部异常感觉也有显著改善(均P < 0.05)。

结论

Medpor植入术可有效恢复眼眶壁骨折患者的眼外肌功能,显著减轻复视、眼球运动障碍及颌面部异常。

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Ocular motility disturbances in orbital wall fracture patients.眼眶壁骨折患者的眼球运动障碍
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本文引用的文献

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Quantitative analysis of diplopia following orbital fracture repair.眼眶骨折修复术后复视的定量分析
Br J Oral Maxillofac Surg. 2023 Apr;61(3):202-208. doi: 10.1016/j.bjoms.2023.01.004. Epub 2023 Feb 2.
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