Diplopia and enophthalmos after surgical repair of blowout fracture

Orbit. 2002 Mar;21(1):27-33. doi: 10.1076/orbi.


Purpose: To evaluate the incidence of residual diplopia and enophthalmos and the possible risk factors leading to their occurrence in patients who had orbital blowout fracture repair.

Methods: Forty-two patients with pure orbital blowout fracture who had at least 6 months postoperative follow-up were included in the study group. Nineteen (45.2%) patients had orbital floor, two (4.8%) patients had medial orbital wall and 21 (50%) patients had a combination of orbital floor and medial orbital wall fractures. The fracture was reconstructed with porous polyethylene (Medpore) in 22, supramide in 12 and gelatin (Gelfilm) in 8 orbits. Mean postoperative follow-up was 11 months.

Results: Preoperatively, 35 patients (83%) had diplopia and 13 patients (30.9%) had enophthalmos greater than 2 mm. Of 35 patients who had preoperative diplopia, only 7 (17%) patients experienced diplopia postoperatively. Diplopia improved 1 to 4 weeks (mean, 3 weeks) following surgery in 28 patients. Timing of surgery and age of the patient were significant for the development of postoperative diplopia (p < 0.05). Sex, location of the blowout fracture and the alloplast material were not found to be significant for the development of postoperative diplopia (p > 0.05). Enophthalmos persisted in three (7%) patients postoperatively.

Conclusion: Old patients were more likely to have residual postoperative diplopia. Surgical repair of blowout fractures within two weeks of trauma decreases the incidence of residual diplopia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Diplopia / etiology*
  • Enophthalmos / etiology*
  • Eye Injuries / surgery*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures / adverse effects
  • Orbital Fractures / surgery*
  • Postoperative Complications*
  • Prostheses and Implants
  • Retrospective Studies
  • Risk Factors
  • Time Factors