A case of traumatic eyeball extrusion with complex, comminuted fractures

PURPOSE: Traumatic extrusion of the eyeball is rare. We experienced and successfully reconstructed a case of the eyeball extrusion with complete avulsion of the optic nerve, and complex, comminuted fractures of medial and inferior orbital walls. METHODS: A 27-year-old man presented with the ocular pain and eyeball extrusion of the right eye after the trauma. There were multiple lacerations of the eyelid and the conjunctiva of the right eye, the complete avulsion of the optic nerve and the avulsion of extraocular muscles except the lateral rectus muscle, and the eyeball extrusion of the right eye. We performed the enucleation with Medpor(R) sphere implantation and the reconstruction of the inferior and medial walls with Medpor(R) one channel and sheet implant. RESULTS: At one-year follow-up, there were no implant exposure and infection, and good cosmetic result was seen without enophthalmos. CONCLUSIONS: In a case of eyeball extrusion with complex, comminuted fractures after trauma, we could reconstruct these successfully with enucleation with Medpor(R) sphere implantation, and repair of fractures with Medpor(R) channel and sheet implant.

Treatment of Complete Traumatic Eyeball Extrusion

The authors have encountered two patients who had complete traumatic eyeball extrusion by trauma with different mechanism. One was a 2-year-old child who fell down from a baby stroller and had the left eyeball extrusion without any trauma to the body except eye. The other was 29-year-old man whose right orbit was pierced by a spit and had right eyeball extrusion too. After the authors reposed traumatic complete eyeball extrusion by Kronlein operation, lateral canthotomy, and antholysis, the authors obtained excellent cosmetic results. Especially, these are very rare cases of the pure eye ball extrusion without another trauma of the body. Therefore, the authors report the experience of the operative treatment of these rare cases.