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

Joseph Kim; Sung Mo Kang

doi:10.3341/jkos.2019.60.2.181

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Kim and Kang: Factors Affecting Persistent Diplopia after Surgical Repair of Isolated Inferior Orbital Wall Fracture

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(2): 181-186.

Published online: 15 February 2019

DOI: https://doi.org/10.3341/jkos.2019.60.2.181

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

Joseph Kim, MD, Sung Mo Kang, MD

Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea.

Address reprint requests to Sung Mo Kang, MD. Department of Ophthalmology, Inha University Hospital, #27 Inhang-ro, Jung-gu, Incheon 22332, Korea. Tel: 82-32-890-2400, Fax: 82-32-890-2417, ksm0724@inha.ac.kr

Received 2 August 2018 Revised 29 September 2018 Accepted 19 January 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Isolated inferior orbital wall fracture, Postoperative diplopia, Surgical repair of orbital wall fracture

Figures and Tables

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.

Table 1

Demographics of the patients

Values are presented as mean ± standard deviation unless otherwise indicated.

EOM = extraocular muscle.

Table 2

Univariable analysis of associations between various factors and postoperative diplopia

CI = confidence interval; EOM = extraocular muscle.

^*p-value was analyzed using logistic regression.

Table 3

Multivariable analysis of associations between various factors and postoperative diplopia

CI = confidence interval; EOM = extraocular muscle.

^*p-value was analyzed using logistic regression.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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