Impact of surgical timing of postoperative ocular motility in orbital blowout fractures. Issue 3 (25th July 2017)

• Record Type: Journal Article
• Authors: Yamanaka, Yukito; Watanabe, Akihide; Sotozono, Chie; Kinoshita, Shigeru
• Is Part Of: British journal of ophthalmology. Volume 102:Issue 3(2018)
• Page Start: 398
• Page End: 403
• Publication Date: 2017-07-25
• Subjects: surgical timing -- orbital blowout fracture -- percentage of hess area ratio (HAR%); Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2017-310312
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Purpose: To investigate the surgical timing postinjury in regard to ocular motility in patients with orbital-floor blowout fractures. Methods: This study involved 197 eyes (92 right eyes and 105 left eyes) of 197 patients (154 males and 43 females, mean age: 29.0 years, range: 7–85 years) with pure orbital blowout fractures. All patients underwent surgical repair within 30 days postinjury and were followed up for 3 months or more postoperative (mean follow-up period: 8.4 months, range: 3–59 months). Orbital blowout fractures were classified into one of three shapes: (1) trap-door fracture with muscle entrapment, (2) trap-door fracture with incarcerated tissue and (3) depressed fragment fracture. Ocular motility was estimated by percentage of Hess area ratio (HAR%) on the Hess chart at the final follow-up examination. In addition, correlations between postinjury surgical timing and HAR% were analysed. Results: The mean postinjury surgical timing was 10.7±7.8 days (range: 0–30 days). The mean postoperative HAR% (92.9%±10.5%) was significantly improved compared with preoperative HAR% (73.5%±21.7%) (p<0.01). The mean postoperative HAR% (98.3%±4.4%) of the orbital-floor trap-door fracture patients with incarcerated tissue who underwent surgical repair within 8 days postinjury was significantly better than that of the patients who underwent surgical repair after 8 days (94.2%±5.8%) (p<0.01). Conclusions: Patients with orbital-floor trap-door blowout fractures with incarcerated tissue that were repaired within 8 days postinjury had better outcomes than those repaired after 8 days, and HAR% is a useful method to record orbital fracture surgical outcomes.