J Korean Ophthalmol Soc.  2016 Aug;57(8):1282-1286. 10.3341/jkos.2016.57.8.1282.

Analysis of Ocular Complications and Blowout Fracture in Orbital Blunt Trauma

• Lim JW
• Yoo JH
• Nam KY
• Lee SU
• Lee SJ

• KMID: 2349076
• DOI: http://doi.org/10.3341/jkos.2016.57.8.1282

Abstract

PURPOSE
To help predict the severity of ocular complications in orbital blunt trauma by analyzing clinical features of ocular complications and orbital wall fracture.
METHODS
A retrospective survey consisting of 169 eyes of 168 patients with orbital blunt trauma who visited Kosin University Gospel Hospital was performed. The patients' age, gender, height, weight, cause of accident, and ocular complications were investigated. The patients were imaged using computer tomography and divided into two groups according to whether they had orbital wall fracture: the orbital contusion group and the orbital wall fracture group. Variables of orbital wall fracture, including the location, length, width, and area were measured using computer tomography in the orbital wall fracture group.
RESULTS
The incidence of ocular complication was 27 of 67 eyes (40.2%) in the orbital wall fracture group and 75 of 102 eyes (73.5%) in the orbital contusion group; ocular complications were found significantly more often in the orbital contusion group than in the orbital wall fracture group (p < 0.001). Among causes of the accident, 'flying object' showed the highest incidence of ocular complication at 40 of 48 eyes (85.1%). In the orbital wall fracture group, there was no significant difference in orbital fracture location, length, width or area between the ocular complication group and the non-ocular complication group.
CONCLUSIONS
Ocular complications were found significantly more often in the orbital contusion group than in the orbital wall fracture group, and 'flying object' showed the highest incidence of ocular complication among causes of the accident.

Keyword

Blowout Fracture; Blunt trauma; Ocular complication

MeSH Terms

Contusions
Humans
Incidence
Orbit*
Orbital Fractures
Retrospective Studies

Figure

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  Figure 1. The measurement of variables of orbital wall fracture. (A-C) Location and anterior to posterior length of orbital wall fracture. For example, Distance A to B: (The number of computed tomography [CT] cross section between A and B) × (CT slice thickness [2 mm or 3 mm]). (A) Both lacrimal crests (red arrows). (B) Starting point of orbital wall fracture (red arrow). (C) End point of orbital wall fracture (red arrow). (D, E) Longest length of orbital wall fracture. (D) Length of medial orbital wall fracture on coronal section. (E) Length of inferior orbital wall fracture on coronal section. (F-I) Orbital wall fracture areas. To calculate the area of the orbital wall fracture, we measured lengths of the orbital wall fracture in all CT section, and then multiplied it by CT slice thickness (2 mm or 3 mm). The sum of these values is orbital fracture area. For example; 4.04 × 3 + 12.49 × 3 + 6.61 × 3 + 7.68 × 3 = Orbital fracture area.

Reference

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