Abstract
Surgery for strabismus secondary to orbital fracture reconstruction surgery has had low success rates and high reoperation rates due to its incomitant nature and complex underlying mechanisms. There has been no consensus as to which of the various methods for improving the surgical results are best. We proposed a modified target angle criteria that combined the regular target angle and a favorable Hess area ratio percentage (HAR%) threshold to evaluate surgical results within the first postoperative week and conducted a retrospective chart review. According to the criteria of the modified target angle at the first postoperative week, a total of 63 patients were divided into two groups: Group 1, patients who fulfilled the criteria (49 patients); and Group 2, those who did not (14 patients). Sex, type of fracture, and the use of porous polyethylene sheets and titanium mesh during reconstruction surgery were significantly different between the groups. Group 1 showed a significantly higher percentage of patients who met the criteria of HAR% > 65% at the first week and >85% (i.e., a successful outcome) at the 6-month visit (p < 0.01). Additionally, Group 1 had a higher HAR% at the first postoperative week (p < 0.01). In conclusion, the patients meeting the criteria of the modified target angle at the first postoperative week had a favorable outcome at the 6-month visit in both ocular alignment and ocular movement.
Highlights
The primary surgical goal of orbital fracture reconstruction is to restore the orbital structure
Diplopia may be the result of a number of different mechanisms, but it can generally be classified as resulting from neurological paresis or a mechanical restriction [7]
We proposed a modified target angle by combining the target angle and a HAR% threshold >65% within the first postoperative week as a parameter for evaluating early surgical results and the final success rate at the 6-month visit in patients who suffer from consecutive strabismus after orbital reconstruction surgery for orbital fractures
Summary
The primary surgical goal of orbital fracture reconstruction is to restore the orbital structure. There is a high incidence of surgical complication after orbital reconstruction surgeries, such as diplopia, enophthalmos lid malposition, and even optic nerve injury [1]. A total of 37–52% of patients experience diplopia after their reconstruction surgery [2,3]. Residual diplopia after orbital reconstruction surgery is reported to be the most common complication and is related to the timing of the reconstruction surgery and the extent of the fracture site [4,5,6]. Different from the principle of volume restoration in orbital reconstruction, treatments for consecutive strabismus-related diplopia are more challenging due to the incomitant nature and underlying mechanisms of the condition
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call