The Effect of Intraoperative Exophthalmometric Values on Enophthalmos Correction in Inferior Orbital Wall Reconstruction

PURPOSE: To measure the enophthalmos corrective effect after inferior orbital wall reconstruction, we compared preoperative and intraoperative exophthalmometric values with postoperative exophthalmometric values. METHODS: From January 2014 to April 2016, 60 eyes of 60 patients who underwent surgery for inferior orbital wall fracture were included. In Group 1, the exophthalmometric value was measured before surgery, during the operation, and 6 months after surgery using the Naugle exophthalmometer. In Group 2, the value was measured before surgery and 6 months after surgery using the Hertel exophthalmometer. The thickness of implants was determined by preoperative exophthalmometric values and overcorrection of 0.5 mm was performed in Group 1 patients with relatively large fractures. RESULTS: The mean age of the patients was 32.4 years in Group 1 and 34.3 years in Group 2. The mean duration between injury and surgery was 4.2 weeks in Group 1 and 2.3 weeks in Group 2. There was no statistically significant difference between preoperative exophthalmometric values in Group 1 (−1.78 ± 0.31 mm) and Group 2 (−1.81 ± 0.26 mm), but postoperative exophthalmometric values between Group 1 (−0.25 ± 0.78 mm) and Group 2 (−0.53 ± 0.46 mm) were statistically different (p = 0.034). CONCLUSIONS: The exophthalmometric values and wall fracture size are important factors for determining implant thickness of inferior orbital wall reconstruction. Intraoperative measurement of exophthalmometric values should be considered in inferior orbital wall reconstruction for enophthalmos correction.

Exophthalmometric Values With Hertel Exophthalmometers in Children

PURPOSE: To investigate the normal exophthalmometric values in children and facilitate the exophthalmic evaluation in pediatric patients with orbital disease. METHODS: We measured 516 eyes in 258 children aged 3 to 9 years without any orbital disease such as thyroid ophthamopathy, orbital pseudotumor and orbital wall fracture. We considered the association of age, sex, binocular variance, inter rim distance and axial length with the exophthalmometric values. Axial length was measured in only 120 eyes of60 patients who underwent operation for strabismus. RESULTS: The mean exophthalmometric values in the patients was 12.43+/-1.55 mm. The exophthalmos had a significant positive correlation with the age, axial length and inter rim distance. There were significant differences in exophthalmometric values by sex in children aged from 8 to 9 years but no significant difference by binocular variance. There were significant differences in the inter-rim distance related to sex. CONCLUSIONS: The exophthalmometric values in children had significant correlation with age, sex, axial length, and inter-rim distance. There was a significant increase of inter-rim distance in males compared to females. Knowing the mean exophthalmometric values in children would be useful with the exophthalmometric reference in pediatric patients with orbital disease.