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Role of orthoptics and scoring system for orbital floor blowout fracture:surgical or conservative treatment

International Journal of Ophthalmology(English edition) 2021年第12期14卷 1928-1934页

作者： juraj timkovic Jiri Stransky Katerina Janurova Petr Handlos Jan Stembirek Clinic of Ophthalmology University Hospital Ostrava17.Listopadu 1790/5Ostrava 70852Czech Republic Department of Craniofacial Surgery Faculty of MedicineOstrava UniversitySyllabova 19Ostrava 70300Czech Republic Clinic of Oral and Maxillofacial Surgery University Hospital Ostrava17.Listopadu 1790/5Ostrava 70852Czech Republic IT4Innovations VSB-Technical University of OstravaStudentská6231Ostrava 70833Czech Republic Department of Forensic Medicine University Hospital Ostrava17.Listopadu 1790/5Ostrava 70852Czech Republic Laboratory of Molecular Morphogenesis Institute of Animal Physiology and Genetics CASVeveří97Brno 60200Czech Republic

AIM:To assess the role of orthoptics in referring patients with orbital floor blowout fracture(OFBF)for conservative or surgical treatment and based on the results,to propose a scoring system for such decision making.METHODS:A retrospective analysis of 69 patients with OFBF was performed(35 treated conservatively,34 surgically).The role of orthoptics in referring to surgery or conservative treatment was retrospectively evaluated,the factors with the highest significance for decision making were identified,and a scoring system proposed using Logistic regression.RESULTS:According to defined criteria,the treatment was unsuccessful in 2(6%)surgically treated and only in one(3%)conservatively treated patient.The proposed scoring system includes the defect size and several values resulting from the orthoptic examination,the elevation of the eyebulb measured on Lancaster screen being the most significant.CONCLUSION:The study demonstrates the benefits of orthoptic examination when making decisions on conservative or surgical treatment and for diagnosing ocular motility disorder(with or without binocular diplopia)in OFBF patients.The proposed scoring system could,following verification in a prospective study,become a valuable adjunctive tool.

关键词： orbital floor blowout fracture scoring system orthoptics ocular motility diplopia conservative treatment surgical treatment

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