J Korean Ophthalmol Soc.  2019 Feb;60(2):181-186. 10.3341/jkos.2019.60.2.181.

Factors Affecting Persistent Diplopia after Surgical Repair of Isolated Inferior Orbital Wall Fracture

• Kim J
• Kang SM

• KMID: 2438078
• DOI: http://doi.org/10.3341/jkos.2019.60.2.181

Abstract

PURPOSE
To investigate factors affecting persistent diplopia after surgical repair of isolated inferior orbital wall fractures.
METHODS
Thirty-three patients who underwent surgical repair of isolated inferior orbital wall fractures in Inha University Hospital Ophthalmology Department from 2014 to 2017 were enrolled in this study. The authors examined facial computed tomography, diplopia, extraocular muscle movement, and Hertel's exophthalmometer before and 6 months after surgery. The diplopia which was not recovered even at 6 months postoperatively was defined as persistent diplopia. Multivariable logistic regression analyses were performed on parameters that were found to be related to persistent diplopia using univariable logistic regression analyses.
RESULTS
Univariable regression analysis showed that preoperative ocular motility limitation, preoperative diplopia, the type of fracture, the number of contacts with the fracture site and extraocular muscle (EOM), and EOM tenting were associated with persistent postoperative diplopia. Multivariable regression analysis using the previously mentioned five parameters showed 28.3-fold and 17.4-fold greater probabilities of diplopia after surgery in preoperative diplopia and EOM tenting, respectively (p = 0.023).
CONCLUSIONS
Preoperative diplopia and EOM tenting were associated with persistent postoperative diplopia. These parameters were predictors of persistent diplopia in eyes with isolated inferior orbital wall fractures.

Keyword

Isolated inferior orbital wall fracture; Postoperative diplopia; Surgical repair of orbital wall fracture

MeSH Terms

Diplopia*
Humans
Logistic Models
Ophthalmology
Orbit*

Figure

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  Figure 1 Fracture type. (A) Open type, extraocular muscle (EOM) displacement, EOM deformity. (B) Close type, EOM tenting (focal angulation). (C) Open type, EOM tenting (focal angulation), contact between EOM and bony edge. (D) Close type, EOM swelling.

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