Journal List > J Korean Ophthalmol Soc > v.52(6) > 1009051

Ryu and Ahn: Effect of Epinephrine in Reconstruction of an Orbital Wall Fracture

Abstract

Purpose

To evaluate the effect of epinephrine on pupil size in reconstruction of an orbital wall fracture.

Methods

The authors of the present study describe 27 patients (27 eyes) who had reconstruction of an orbital wall fracture from January to July of 2009. Patients were divided into two groups according to the use of epinephrine during surgery. Preoperative and postoperative pupil sizes, operation times, and epinephrine dosages were collected.

Results

Preoperative pupil sizes were 1.80 ± 0.37 mm, 1.74 ± 0.36 mm and postoperative pupil sizes were 1.97 ± 0.43 mm (p = 0.042), 2.18 ± 0.52 mm (p = 0.003) in the group with of epinephrine and the group without epinephrine, respectively. Postoperative pupil size significantly increased in all groups. However, no significant difference was found regarding change in pupil size after surgery (p = 0.258). In the group with epinephrine, change in pupil size did not show a significant association with operation time (p = 0.228), nor did change in pupil size and epinephrine dosage (p = 0.922).

Conclusions

The use of epinephrine is an effective modality for bleeding control and securing a clear view in orbital wall fracture reconstruction.

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Figure 1.
The comparison that displays the change in pre- and post-operative pupil size (Repeated measures ANOVA, p = 0.258). Inj. = epinephrine injection.
jkos-52-653f1.tif
Figure 2.
The change in pupil size by operation time in epinephrine injection group (Linear regression, p = 0.228).
jkos-52-653f2.tif
Figure 3.
The change in pupil size by amount of injection in epinephrine injection group (Linear regression, p = 0.922).
jkos-52-653f3.tif
Table 1.
Demographic characteristics of patients
Age (yr) Male Female Total
1-20 7 3 10
21-40 9 2 11
41-60 4 1 5
61-80 1 0 1
Total 21 6 27
Table 2.
Causes of orbital wall fracture
  No. of patients (%)
Assault 15 (55.5)
Traffic accident 9 (33.3)
Sports 3 (11.2)
Total 27 (100)
Table 3.
The change in pupil size of study group and control group (Paired t-test)
  Pre op. pupil size (mean ± SD, mm) Post op. pupil size (mean ± SD, mm) p-value
Inj. (+) 1.74 ± 0.36 2.18 ± 0.52 0.003
Inj. (−) 1.80 ± 0.37 1.97 ± 0.43 0.042

Inj. = epinephrine injection.

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