title: Surgical timing and postoperative ocular motility in type B orbital blowout fractures.
abstract: OBJECTIVE
  To determine whether patients with Type B orbital blowout fractures (soft-tissue distortion disproportionate to bone-fragment displacement) repaired within 7 days of injury have statistically greater postoperative vertical binocular fusion than similar patients who undergo later surgery.
  
  
  METHODS
  Prospective and retrospective surgical case series. Inclusion criteria were orbital floor (with or without medial wall) blowout fracture repair, preoperative coronal orbital CT scans, and patient age of at least 12 years at time of postoperative binocular visual field.
  
  
  RESULTS
  Twenty-five patients met inclusion criteria. Ten patients (group 1) had surgery within 7 days of injury, and 15 patients (group 2) had surgery more than 7 days after injury. The total cohort had a median postoperative vertical binocular fusion of 90°. Group 1 had postoperative vertical binocular fusion averaging 100°. Nine of 10 patients (90%) were above and 1 of 10 (10%) were below the median for the entire cohort. Group 2 had postoperative vertical binocular fusion averaging 70°. Three of 15 patients (20%) were above and 12 of 15 patients (80%) were below the median for the entire cohort. The difference between the average postoperative vertical binocular fusion of the 2 groups was statistically significant by two-tailed unpaired t test with p value 0.0022.
  
  
  CONCLUSIONS
  Patients with Type B orbital blowout fractures (soft-tissue distortion disproportionate to bone-fragment displacement) have statistically greater average postoperative vertical binocular fusion if repaired within 7 days of injury than similar patients who undergo later surgery.
authors.affiliation: *Department of Ophthalmology, Medical College of Wisconsin-The Eye Institute, Milwaukee, Wisconsin; and †Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A.
authors.forename: Janice C
authors.initials: JC
authors.lastname: Liao
authors.forename: Valerie I
authors.initials: VI
authors.lastname: Elmalem
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Wells
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Harris
mesh_terms: D000328:Adult; D000368:Aged; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D015348:Vision, Binocular / Q000502:physiology*; D014794:Visual Fields / Q000502:physiology*