The Analysis of Causes of the Postoperative Enophthalmos in Adult Blowout Fractures

ABSTRACT

PURPOSE: To evaluate clinical characteristics of adult blowout fractures who underwent orbital wall reconstruction and relationships between clinical factors and post operative complications. METHODS: The medical records of 29 patients with orbital blowout fractures who underwent orbital wall reconstruction were retrospectively reviewed from March, 2000 to November, 2001. Various clinical factors including cause of insult, fracture size, associated injuries, and preoperative enophthalmos were evaluated. Further factors which causes late postoperative enophthalmos were analyzed. RESULTS: Blowout fracture occurred most frequently between the ages of 20 and 29 years and was more common in male than female. The violence was the most common cause, and the most common fracture site was inferior wall combined with medial wall. After surgery extraocular movement limitation and diplopia were improved or eliminated. Preoperative mean enophthalmos was 2.83 mm and postoperative mean enophthamos was 1.27 mm. Fracture size was more predictable to late postoperative enophthalmos than the degree of preoperative enophthalmos measurement (Percent of Predication; with preoperative enophthalmos = 25%, with fracture size = 52%, p<0.05). CONCLUSIONS: In adult, the size of blowout fracture was large. Therefore enophthalmos was common complication after orbital wall reconstruction. The estimation of fracture size by using computed tomography was more predictable to late postoperative enophthalmos and easily accessible in clinic room as well as simple, therefore it is helpful to decide the early surgical reduction.