Ophthalmic Complications Associated with Zygomatic Complex Fractures: A Randomised Descriptive Clinical Study
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ORIGINAL ARTICLE
Ophthalmic Complications Associated with Zygomatic Complex Fractures: A Randomised Descriptive Clinical Study Rayan Malick1,2 • M. E. Sham1 • Suresh Menon1 • Veerendra Kumar1 S. Archana1 • Sheron Mathews1
•
Received: 5 March 2020 / Accepted: 25 August 2020 The Association of Oral and Maxillofacial Surgeons of India 2020
Abstract Background and Objectives Trauma to the maxillofacial region is usually associated with varying degrees of disruption of the soft and hard tissues in the region and injuries to the neighbouring structures such as eyes, brain, nasal apparatus and paranasal sinuses. Injuries to the middle third of the face commonly destroys the integrity of the orbital skeleton, and are frequently complicated by injury to the eye, ranging between 2.7 and 67% as reported in the literature. These injuries may result in loss of vision or compromised ocular function. When these injuries are severe, they may be detected with ease by any medical or maxillofacial surgeon but many injuries appear minimal and may be missed by the non-ophthalmologist. Methods A total of thirty patients were selected who were diagnosed with a zygomatic complex fracture, irrespective of sex predilection and in the age group of 18–70 years. All patients underwent a thorough ophthalmic examination by an Oral and Maxillofacial Surgeon and an Ophthalmologist preoperatively and on postoperative day 2, and 7 and all findings were documented separately by the surgeon and the ophthalmologist and the findings were later compared. Results The statistical analysis was performed using SPSS VERSION 21.0, Shapiro–Wilk test which was used to assess the normality. Descriptive analysis was done for age and gender distribution of study subjects, which are
& Rayan Malick [email protected] 1
Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences and Research Centre, Bangalore, India
2
18/2 Alexandra Street, Myrtle Lane, Ishal Manor, 2nd Floor, Richmond Town, Bengaluru 560025, India
expressed as number and frequency. Cochran’s q test was used to determine if there are differences in various study factors among OMFS and ophthalmologists at three time intervals which are expressed as number and frequency. Kappa agreement was used to assess the measurement of agreement between OMFS and ophthalmologists for each factor at each time interval and these are expressed as number and frequency, and p B 0.05 is considered as statistically significant. Upon examination by an OMFS periorbital oedema (p = 0.000), periorbital ecchymosis (p = 0.002), chemosis (p = 0.02) and exophthalmos (p = 0.03) were considered clinically significant. Upon examination by an ophthalmologist subconjunctival haemorrhage (p = 0.05), periorbital oedema (p = 0.05), periorbital ecchymosis (p = 0.00), ptosis (p = 0.006), enopthalmos (p = 0.05) and diplopia (p = 0.05) were considered to be clinically significant. Upon correlation of the findings of the surgeon and the ophthalmologist it was seen that certain parameters like corneal injury, P
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