ABSTRACT
PURPOSE: To investigate intraocular pressure (IOP) changes in the involved eye during orbito-zygomatic complex fracture reduction, compared with the IOP of the eye on the uninjured side. PATIENTS AND METHODS: Twenty patients who presented with displaced, isolated unilateral orbito-zygomatic complex fractures were enrolled. IOPs were measured using a Tono-Pen XL (Medtronic Solan, Jacksonville, FL) in the involved eye and in the non-involved eye. Pressure was recorded at 5 time points (before general anesthetic induction, after induction, immediately after fracture reduction, post operation while still under general anesthetic, and 15 minutes post general anesthetic). RESULTS: There were no significant differences between the injured and control data at any time point. Average IOPs for the involved and control eye decreased after anesthetic induction; however, IOP increased in both eyes after fracture reduction. CONCLUSION: There is no statistical evidence of a difference between the IOP of the control and injured eyes. Routine IOP testing is not indicated during orbito-zygomatic fracture reduction.
Subject(s)
Intraocular Pressure/physiology , Orbital Fractures/surgery , Zygomatic Fractures/surgery , Adolescent , Adult , Anesthetics, General/administration & dosage , Bone Transplantation , Eye Movements/physiology , Female , Follow-Up Studies , Fracture Fixation, Internal , Humans , Intraocular Pressure/drug effects , Joint Dislocations/surgery , Male , Middle Aged , Reflex, Pupillary/physiology , Tonometry, Ocular , Visual Acuity/physiologyABSTRACT
PURPOSE: Fifty-eight patients (average age, 60 years) with gross mandibular atrophy had transmandibular implants inserted between 1984 and 1988. This study reports on their progress at 5 and 15 years. PATIENTS AND METHODS: In both 1991 and 2000, 50 cases were reviewed, with the other 8 lost to follow-up. Detailed surveys, using exactly the same format, were conducted to determine the outcome of transmandibular implant treatment. The records were reviewed and surviving patients with transmandibular implants were examined. RESULTS: An overall success rate of 80% in 1991 had fallen to 56% by 2000, with a total of 22 implants being removed. CONCLUSION: Factors involved in failure were age and medical infirmity of the patients, gross mandibular atrophy, and the use of several surgeons, in particular, trainees. This survey shows that the TMI has a progressive long-term failure rate and that extreme care needs to be taken in both patient selection and implant placement.
