Factors Influencing Postsurgical Diplopia in Orbital Floor Fractures and Prevalence of Other Complications in a Series of Cases

Abstract

We conducted a review of orbital fractures treated in our hospital over a period of 4years. We reviewed several complications of such fractures, especially the relationship of postsurgical diplopia with different presurgical variables: age, gender, type of fracture, fracture area, coronal and sagittal diameter of fracture, fractured floor area, time to surgery, presence of muscle herniation, and presence of muscle entrapment. Fractures involving the orbital floor remain a controversial issue in terms of surgical treatment and the time from trauma to surgery.Surgical indications are divided into esthetic and functional, and they greatly differ from one medical center to another. We observed that the variables that influence postoperative complications varied in the different studies reviewed. Postsurgical diplopia is one of the most important complications, and its relationship with presurgical variables was the focus of this study. For the purpose of this study, we performed bivariate and multivariate analyses, accepting P<.05 as significant. According to the multivariate analysis, postsurgical diplopia was only associated with trapdoor fractures, regardless of all other variables, especially if these fractures were operated on after 48hours. In addition, the bivariate analysis showed that fractures involving muscle herniation resulted in less diplopia and a better prognosis if operated on before 48hours. However, these results were not statistically significant. Surgery performed within 48hours of trauma statistically improves fractures with truemuscle entrapment and also, fractures with muscle hernation (although in this fractures, the improvement is not statistically significant).