Analysis Of Diplopia And Ocular Movement Dysfunction After Orbital Wall Fracture And Its Related Factors

Objective: To explore the relationship between diplopia and ocular movement dysfunction in patients with orbital wall fracture and its related influencing factors,so as to provide reliable theoretical guidance for clinical treatment.Methods:In this study,a retrospective analysis was conducted to collect and select from 189 patients who underwent orbital wall fracture repair in the ophthalmology group of the Affiliated Hospital of Yan Bian University between September 2018 and June 2020,and 73 patients who met the requirements were screened out.Surgical repair of orbital wall fracture was performed after conjunctival approach was confirmed by the same physician.Preoperative and postoperative eye position,eye movement,eyeball invagination(or protrusion),diplopia and other indicators of the patients were classified and the causal relationship was analyzed.Results:1.More than 60% of the patients with orbital wall fracture are caused by fist injury,mainly on the inner wall and lower wall of the right eye.2.There was a significant correlation between the degree of eyeball depression before operation and the time from injury to operation,P=0.0001(P < 0.05);There was also a positive correlation between the two postoperatively,P=0.007(P < 0.05).3.There was a significant correlation between preoperative degree of eyeball depression and total fracture area,P = 0.01(P < 0.05);there was no significant correlation between postoperative degree of eyeball depression and total fracture area,P = 0.157(P > 0.05);there was a significant correlation between preoperative and postoperative degree of eyeball depression and total fracture area,P = 0.01.4.In 73 cases of orbital wall fracture,6 cases recovered diplopia(or no diplopia)within 48 hours;50 cases recovered diplopia(or no diplopia)within 2-14 days;15cases recovered diplopia(or no diplopia)more than 14 days after operation,4 cases recovered diplopia(or no diplopia).The recovery of diplopia was 20 / 33(60.6%).5.In 73 cases of fracture patients,8 cases(100%)received surgery within 48 hours,34 cases(68%)within 2-14 days,and 4 cases(26.7%)after 14 days.Two weeks later,87.5%(14 / 16)of the patients had tissue adhesion.Conclusion:1.The preoperative degree of eyeball depression,fracture area and the time of operation are the important influencing factors of postoperative diplopia and limited eye movement.2.The formation of tissue adhesion at the fracture site is one of the factors that aggravate the occurrence of diplopia eye movement limitation.