Management of diplopia in patients with blowout fractures.
OBJECTIVE
To report the management outcomes of diplopia in patients with blowout fracture.


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.
Department of Ophthalmology, Gulhane Military Medicine Academy, Ankara, Turkey. drmelihceylan@hotmail.com
Osman Melih
OM
Ceylan
Yusuf
Y
Uysal
Fatih Mehmet
FM
Mutlu
Kemal
K
Tuncer
Halil Ibrahim
HI
Altinsoy
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004172:Diplopia / Q000209:etiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D009917:Orbital Fractures / Q000150:complications* / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult