Management of diplopia in patients with blowout fractures

Purpose: To report the management outcomes of diplopia in patients with blowout fracture. Materials and Methods: Data for 39 patients with diplopia due to orbital blowout fracture were analyzed retrospectively. The inferior wall alone was involved in 22 (56.4%) patients, medial wall alone was involv...

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Bibliographic Details
Main Authors: Osman Melih Ceylan, Yusuf Uysal, Fatih Mehmet Mutlu, Kemal Tuncer, Halil Ibrahim Altinsoy
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2011-01-01
Series:Indian Journal of Ophthalmology
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Online Access:http://www.ijo.in/article.asp?issn=0301-4738;year=2011;volume=59;issue=6;spage=461;epage=464;aulast=Ceylan
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Summary:Purpose: To report the management outcomes of diplopia in patients with blowout fracture. Materials and Methods: Data for 39 patients with diplopia due to orbital blowout fracture were analyzed retrospectively. The inferior wall alone was involved in 22 (56.4%) patients, medial wall alone was involved in 14 (35.8%) patients, and the medial and inferior walls were involved in three (7.6%) patients. Each fracture was reconstructed with a Medpore® implant. Strabismus surgery or prism correction was performed in required patients for the management of persistent diplopia. Mean postoperative follow up was 6.5 months. Results: Twenty-three (58.9%) patients with diplopia underwent surgical repair of blowout fracture. Diplopia was eliminated in 17 (73.9%) patients following orbital wall surgery. Of the 23 patients, three (7.6%) patients required prism glasses and another three (7.6%) patients required strabismus surgery for persistent diplopia. In four (10.2%) patients, strabismus surgery was performed without fracture repair. Twelve patients (30.7%) with negative forced duction test results were followed up without surgery. Conclusions: In our study, diplopia resolved in 30.7% of patients without surgery and 69.2% of patients with diplopia required surgical intervention. Primary gaze diplopia was eliminated in 73.9% of patients through orbital wall repair. The most frequently employed secondary surgery was adjustable inferior rectus recession and <17.8% of patients required additional strabismus surgery.
ISSN:0301-4738
1998-3689