Analysis Of Postoperative Diplopia Related Factors Of 52 Cases Of Pediatric Orbital Blowout Fracture

Objective: To discuss and summarize the clinical characteristics of children with orbital blowout fracture(OBF)in various age groups,analyze the factors associated with the recovery time of diplopia and the risk factors associated with postoperative residual diplopia,and provide a clinical reference for predicting the regression of postoperative diplopia in children with OBF.Methods: Retrospective analysis of pediatric patients with OBF who visited the ophthalmology department of Beijing Road Medical clinical center of Xinjiang Military Region General Hospital between January 2010 and October 2022.Age,gender,cause of injury,fracture site,the interval between injury and surgery,diplopia and ocular motility,prominence of the eye,surgical procedure,and time to remission of diplopia after surgery were recorded.The clinical characteristics of children in the 0-12 and 13-18 years old groups were compared,and the risk factors causing postoperative residual diplopia were analyzed by Rank correlation analysis to calculate which factors were related to the time of diplopia disappearance and logistic regression.Results: A total of 52 patients(52 eyes)were included in this study,with a male-to-female sex ratio of 7.7:1.The age range was 5-18 years(mean 12.46±3.76 years),the most common cause of injury was boxing injury in a total of 21 patients(40.38%),the inferior orbital wall was the most common site of fracture(67.31%),and the most common type of extraocular muscle injury was extraocular muscle restrictive function injury(34.62%).The incidence of diplopia was 92.31%,the oculomotor restriction was65.38%,ocular depression was 23.08%,and nausea and vomiting were 36.54%.The time range from injury to undergoing surgery was 2-180 days(mean 23.10±27.73).The younger age group(0-12 years)had a higher incidence of diplopia,limited eye movements,and nausea and vomiting than the older age group(13-18 years),and the incidence of orbital depression was higher in the older age group than in the younger group.None of the postoperative cases had serious complications such as implant infection and vision loss.41 of the 48 patients with preoperative diplopia had complete disappearance of diplopia,with disappearance times of 1-64 w(mean 21.49±15.40 w).The time to the disappearance of diplopia was significantly correlated with patient age,time from injury to surgery,type of extraocular muscle injury,and symptoms of oculomotor restriction.The time to the disappearance of diplopia after surgery was longer in the age group,the late(>14 days)surgery group,the group with paralytic damage to the extraocular muscles,and the group with oculomotor limitation.7 patients had postoperative residual diplopia.Age(P<0.05)was an associated risk factor for the development of postoperative residual diplopia.Conclusion: 1.Orbital floor fractures are the most common fracture site for OBF in children,with boxing injuries most common in older children and impact injuries most common in younger children.2.Diplopia and limited eye movements are the most common clinical manifestations of OBF in children.3.The time to loss of diplopia after surgery is significantly longer in children with late surgery,paralytic injury to the extraocular muscles,and limited eye movements.4.Children in younger age groups The postoperative diplopia disappears for a longer time and is more likely to have postoperative residual diplopia.