The Postoperative Recovery of Ocular Motility in Pediatric Blow-out Fracture

PURPOSE: To evaluate the clinical presentation, type of fracture, time of intervention and postoperative restoration of ocular motility disturbance in pediatric blow-out fracture. METHODS: The authors reviewed medical records of 30 consecutive cases which were operated for blowout fracture from January 1998 to December 2000. RESULTS: The most common cause of injury was violence (80%). The most common location of fracture was inferior wall (50%), followed by inferior-medial wall (30%). The most common type of fracture was trap door type fracture. The trap door type fracture showed much severe ocular motility disturbance preoperatively. Six cases of trap door fracture showed ocular motility restriction postoperatively. Early surgical intervention (within 5 days) resulted in a more complete return of ocular motility compared with the late intervention group (p<0.05). CONCLUSIONS: Trap door fracture was the most common type of orbital fracture in the pediatric age group. Early surgical intervention within 5 days will improve ocular motility postoperatively.

5 cases of Infected Hydroxyapatite Orbital Implant

PURPOSE: To describe the rare condition of an infection of hydroxyapatite orbital implant in five patients who had undergone seemingly uncomplicated evisceration and implantation of hydroxyapatite orbital implant. METHODS: The infection of hydroxyapatite orbital implant developed from 6 months to 6 years (mean 3 years 4months) after evisceration and from 3months to 6years (mean 2years 7months) after drilling. In all cases, lid swelling, conjunctival injection and implant exposure were observed. In 3 cases, the hydroxyapatite orbital implant was removed and Medpor(R) implantation was done. In 2 cases, the hydroxyapatite orbital implant was removed and dermis fat graft was done simultaneously. RESULTS: In all five cases the inflammation signs disappeared and conjunctival sac was well formed for artificial eye fitting after treatment. CONCLUSIONS: We experienced 5 cases of infected hydroxyapatite orbital implant, and treated them successfully.

Strabismus with Ocualr Motility Disturbance after Molteno Implant

PURPOSE: We experienced a case of ocular motility disturbance with esotropia and hypotropia, following implantation of Molteno to the superotemporal quadrant. METHODS: The patient recovered to orthophoria after removal of implant and fibrotic scar tissue with recession and resection. RESULTS: Multiple complications have been reported in association with Molteno implantation, including hypotony, cataract, choroidal hemorrhage, retinal detachment, endophthalmitis, hyphema, phthisis. However ocular motility disturbances have been documented in only a few cases and never in Korea to our knowledge. Therefore, we report this case with the review of related literatures.