早期手术治疗眼眶爆裂性骨折的视功能评估

Assessment of visual function after Surgical treatment caused by early orbital blow-out fracture

目的探讨早期眼眶爆裂性骨折Medpor填充治疗效果,评估术后患者的视功能恢复情况。方法回顾28例(28只眼)眼眶爆裂性骨折患者的病例资料,观察患者手术前术后视力、眼球突出度、眼外肌运动及复视等情况。结果术后随访3个月至4年,28例患者术后均未出现患眼明显视力下降和视力丧失,术后眼球内陷度数为(1.5±0.6)mm,与术前(3.6±1.1)mm相比,差异有统计学意义(P<0.05)。术后3个月,25例患者复视完全消失,2例患者第一眼位无复视,但仍有周边复视,1例术后第一眼位复视仍存在。26例术后眼球运动基本恢复正常,2例外展稍受限,但较术前好转。以上28例患者均未发现填充物移位、感染或排异反应。结论早期诊断、早期治疗及术后早期运动训练,是治疗效果的关键。Medpor填充治疗眼眶爆裂性骨折所致复视、眼球内陷,临床效果安全可靠。

Objective To study the effect that medpor implant repair early orbital blow-out fractures and assess the visual function after surgical reconstruction caused by orbital blow-out fractures.Methods Retrospective study and analysis was made on and of 28 orbital blow-out fracture patients who received early orbital reconstruction,The variations in the visuaacuity,diplopia,enophthalmos degree and eyeball position were detected.Results During the follow up of three months to four years after operation,all the 28 cases Showed neither loss nor distinct descent of visual acuity.The post operative mean enophthalmos degree（1.5 ± 0.6） mm was lower than the preoperationone（3.6 ± 1.1） mm（P 0.05）.Diplopia disappeared completely of 25cases during 3 months after operation,while it appeared in the primary position of 2 cases.The eye movement was normal of 26 cases after operationt,and the abduction wass lightly limited of 2 cases,but which was better than before）.Any displacement of filling material,infection,rejection reaction were not found of all the 28 cases.Conclusion Early diagnosis,Early treatment and early postoperative exercisetraining are the key to fine curative effect.The clinical effects of diplopia caused by Blow-out Fracture patients having received orbital reconstruction with Medpor implantantion is safe and reliable,so medpor implants are worth popularization and application widely.