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N.A. Kazim, E. Black; Ocular Complications in Patients With Orbital Wall Fractures . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3968.
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To determine the incidence of ocular complications in patients with orbital wall fractures at the Kresge Eye Institute and investigate the correlation between the location of the orbital wall fracture and ocular complications.
This was a retrospective descriptive case study that reviewed all patients who presented to the Kresge Eye Institute with orbital wall fractures over an 18 month period. The mechanisms of injury, the locations of the orbital wall fractures, and associated ocular complications were analyzed. Patients younger than 18 years of age were excluded.
169 consecutive patients with an average age of 40.8 ± 14 years were evaluated. There was a male preponderance with 133 males (78.7%) and 36 females (21.3%). Assault was the major cause of injury and constituted 69.2%. Most of the orbital wall fractures occurred on the left side (61.5%). The monthly distribution of incidence of injury showed November to be the month in which the greatest number of orbital wall fractures occurred (8.9%). The most common orbital involved was the inferior wall (38.7%), followed by medial (30.1%), lateral (26.0%), and superior (5.1%). There were a total of 490 associated ocular injuries. More temporary ocular complications occurred at an increased incidence (e.g. periorbital edema 87%, subconjunctival hemorrhage 62%, chemosis 46%, commotion retinae 25%). More serious ocular sequelae occurred at a less frequent incidence (e.g. vitreous hemorrhage 2%, hyphema 1%, choroidal rupture 1%, traumatic macular hole 1%). Medial wall fractures were associated with the greatest number of ocular injuries (56.2%). There was no statistically significant association between ocular complications and orbital wall fracture location (P=0.5062).
Orbital wall fractures are frequently associated with ocular complications. Inferior orbital wall fractures occurred most frequently. There was no statistically significant association between ocular complications and orbital wall fracture location. However, patients with medial wall fractures had the greatest number of ocular injuries. Therefore, patients with medial wall fractures may be at an increased risk for ocular complications.
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