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Prediction of the development of late enophthalmos in pure blowout fractures: delayed orbital tissue atrophy plays a major role

Abstract

Purpose

To retrospectively evaluate the risk factors for the development of late enophthalmos in pure blowout fractures.

Methods

We reviewed 49 cases of pure blowout fractures diagnosed in Ajou University Hospital, South Korea, from January 2005 to June 2015. We assumed that several factors influence the development of late enophthalmos, including bony defect size, volume of displaced soft tissue, number of fracture sites, involvement of floor, soft tissue incarceration through the bony defect, and patient age.

Results

Twenty-one patients were diagnosed with late enophthalmos (group 1) while 28 patients were not (group 2). Soft tissue incarceration, presumably causing the soft tissue injury, was the only factor that increased the risk for late enophthalmos in this study (p = 0.04, odds ratio 4.5). In contrast with previous studies, there were no meaningful correlation between bony defect size or volume of displaced soft tissue and development of late enophthalmos. Number of fracture sites, involvement of floor, and patient age did not increase the risk for late enophthalmos.

Conclusions

We suggest that the delayed orbital tissue atrophy due to soft tissue injury plays a more important role than other hypotheses in the development of late enophthalmos. It is necessary to overcorrect to some extent if there is soft tissue incarceration through the bony defect in the initial computed tomography, and clinicians should warn patients about the development of late enophthalmos despite orbital reconstructive surgery.

Eur J Ophthalmol 2017; 27(1): 104 - 108

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ejo.5000801

Authors

Sue Min Kim, Yeon Seong Jeong, Il Jae Lee, Myong Chul Park, Dong Ha Park

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

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Authors

Affiliations

  • Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Republic of Korea

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