Clinical Signs and Intraocular Pressure Changes in Patients with Orbitozygomatic Complex Fractures
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ORIGINAL ARTICLE
Clinical Signs and Intraocular Pressure Changes in Patients with Orbitozygomatic Complex Fractures Olasunkanmi F. Kuye1 • Olawunmi A. Fatusi2 • Folusho J. Owotade2 Samuel O. Olateju3 • Oluwatoyin H. Onakpoya3
•
Received: 19 September 2018 / Accepted: 12 October 2019 Ó The Association of Oral and Maxillofacial Surgeons of India 2019
Abstract Objectives The study investigated the association between intraocular pressure changes and clinical ocular signs in 51 patients with orbitozygomatic complex fractures. Diplopia, chemosis, enophthalmos, subconjunctival haemorrhage, periorbital ecchymosis and extraocular muscles entrapment were assessed. Study Design Intraocular pressure was measured in mmHg at different time intervals with Perkins and Goldman tonometers; within first 3 days of injury (T1), 24 h postelevation within 3–14 days of injury (T2), 1 month after initial treatment assessment (T3), 2 months after initial treatment assessment (T4), and 3 months after initial treatment assessment (T5). Intraocular pressure changes between T2/T1 and T3/T1 were analysed as change 1 and
change 2, respectively, with paired t test. Significance was set at p \ 0.05. Results Minimum intraocular pressure recorded in the affected eye was 5 mmHg at T1 and T2, while maximum intraocular pressure was 28 mmHg at T1. Mean intraocular pressure at T1 and T2 was 15.90 ± 4.73 mmHg and 16.80 ± 4.43 mmHg, respectively. All eye signs had completely resolved at T3 except enophthalmos, which persisted till T5. Statistical significant relationship exist between orbitozygomatic complex fracture and enophthalmos (T1: p = 0.04). subconjunctival haemorrhage (T2: p = 0.003), periorbital ecchymosis (T2: p = 0.005),and T3: p = 0.001). Conclusion Chemosis, diplopia, enophthalmos, periorbital ecchymosis and subconjunctival haemorrhage showed positive contributory effect to intraocular pressure elevation in orbitozygomatic complex fracture.
& Olasunkanmi F. Kuye [email protected]
Keywords Trauma Orbitozygomatic complex fractures Intraocular pressure changes Ocular eye signs Blindness
Olawunmi A. Fatusi [email protected] Folusho J. Owotade [email protected]
Introduction
Samuel O. Olateju [email protected]
Zygomatic complex fractures involving the orbit are among the most frequent midface fractures in maxillofacial trauma and next in frequency to nasal complex fractures [1]. The zygomatic bone is intimately associated with the maxilla, frontal, temporal and the sphenoidal bones, making it a tetrapod complex form of articulation [1]. Zygomatic complex fractures can occur in isolation or in combination with any of the neighbouring associated bones. The high incidence of the zygomatic fractures probably relates to its prominent position within the facial
Oluwatoyin H. Onakpoya [email protected] 1
Lagos State University College of Medicine, Faculty of Dentistry, Ikeja, Lagos, Nigeria
2
Department Of Oral/Maxillofacial Surgery and Oral pathology, Faculty Of Dentistry, Obafemi Awolowo University, Ife, Osun, Nigeri
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