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Lee, Lee, Shin, Lee, Jang, and Baek: Significant Intraocular Sequelae in Orbital Blunt Trauma and Their Association with Blowout Fracture
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(5): 613-617.

Published online: 16 May 2012

DOI: https://doi.org/10.3341/jkos.2012.53.5.613

Significant Intraocular Sequelae in Orbital Blunt Trauma and Their Association with Blowout Fracture

Joon Sik Lee, MD1, Hwa Lee, MD1, Hyoungho Shin, MD2, Jongmi Lee, MD3, Minwook Jang, MD1, Sehyun Baek, MD, PhD1

1Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.

2Cheonan Kim's Eye Clinic, Cheonan, Korea.

3Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Address reprint requests to Sehyun Baek, MD, PhD. Department of Ophthalmology, Korea University Ansan Hospital, #123 Jeokgeum-ro, Danwon-gu, Ansan 425-707, Korea. Tel: 82-31-412-5160, Fax: 82-31-414-8940, shbaek6534@korea.ac.kr

Received 4 August 2011       Accepted 24 March 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To investigate the frequency of significant intraocular sequelae (SIOS) in orbital blunt trauma and their association with blowout and facial bone fractures.

Methods

A retrospective survey consisting of 726 patients with orbital blunt trauma who visited Korea University Medical Center was performed. Patients were divided into three groups: blowout fracture only group (group 1), facial bone fracture group (nasal bone fracture, maxillary fracture, zygoma fracture without blowout fracture, group 2), and non-fracture group (group 3). SIOS (traumatic iridocyclitis, commotio retina, hyphema, retinal hemorrhage, eyeball rupture, vitreous hemorrhage, retinal detachment, lens dislocation, traumatic cataract) were surveyed in each group, and the association between the frequency of SIOS and the presence of blowout fracture or facial bone fracture was analyzed.

Results

The frequency of SIOS in the fracture groups was 83.8% in group 1 and 73.3% in group 2, which were both higher than the 67.9% in group 3, the non-fracture group (p = 0.000 by chi-square linear by linear association). Traumatic iridocyclitis and hyphema were also significantly higher in groups 1 and 2 than group 3 (p = 0.003, p = 0.008 by chi-square linear by linear association).

Conclusions

SIOS was found significantly more often in the fracture group than the group without fracture, although the frequency of severe SIOS was lower in the fracture group than the non-fracture group. The results from the present study could help in the treatment and management of patients with orbital blunt trauma.

Keywords: Blowout fracture, Facial bone fracture, Orbital blunt trauma, Significant intraocular sequelae

Figures and Tables

Table 1
Patient demographics
jkos-53-613-i001

*Blowout fracture group; †Facial bone fracture group (nasal bone, zygoma, maxillary fracture without blow out fracture); ‡Non-fracture group.

Table 2
Initial visual acuity
jkos-53-613-i002

Values are presented as number (%).

NLP = non light perception; LP = light perception; H.M = hand motion.

*Blowout fracture group; †Facial bone fracture group (nasal bone, zygoma, maxillary fracture without blowout fracture); ‡Non-fracture group.

Table 3
Frequency of significant intraocular sequelae in orbital blunt trauma
jkos-53-613-i003

Values are presented as number (%).

*Blowout fracture group; †Facial bone fracture group (nasal bone, zygoma, maxillary fracture without blowout fracture); ‡Non-fracture group; §Based on chi-square linear by linear association.

Table 4
Frequency of significant intraocular sequelae between fracture group and non-fracture group*
jkos-53-613-i004

Values are presented as number (%).

*p-value = 0.000 by pearson chi-square.

Table 5
Association between the number of fracture and the frequency of significant intraocular sequelae*
jkos-53-613-i005

Values are presented as number (%).

*Fractures are consisted of medial wall fracture, inferior wall fracture, orbital roof fracture, nasal bone fracture, zygoma fracture, maxillary fracture; †The number of fracture is 0; ‡The number of fracture is 1; §The number of fracture is 2; ∥The number of fracture is 3; #Based on chi-square linear by linear association.

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