Background: To evaluate the patterns of distribution and clinical manifestations of ocular injuries referred to the level 1 trauma center of Pusan National University Hospital (PNUH) in Korea. Methods: We analyzed 254 of 4,287 patients who were referred to the Department of Ophthalmology at the level 1 trauma center of the PNUH, from January 2016 through December 2018. Data on the incidence of ocular injuries, sex, age, monthly and seasonal distribution, day and time of injury, side of injury, cause, residence of patients, referral time to an ophthalmologist and subsequent examination time, final visual acuity (VA), and complications were obtained from medical records and retrospectively reviewed. The patients were grouped according to their main diagnosis using the Birmingham Eye Trauma Terminology System (BETTS) and Ocular Trauma Score (OTS). Results: The incidence of ocular injuries with major trauma was higher in men (n = 207, 81.5%), the median age at time of injury was 54 years, and Pusan recorded the most cases.

Background: Detachment of the inferior oblique muscle may be necessary under certain circumstances to repair a large inferomedial orbital fracture involving the orbital strut. This study aimed to evaluate the outcomes of patients who underwent surgeries with and without inferior oblique muscle reattachment after its detachment to repair the orbital wall fractures. Methods: Forty patients who underwent repair of combined floor and medial orbital wall fracture involving the orbital strut at a single tertiary institution between January 2014 and December 2020 were reviewed. Groups 1 and 2 comprised 20 patients each, who underwent surgery with inferior oblique muscle detachment without and with reattachment, respectively, and were followed up for at least 6 months postoperatively. Enophthalmos, Goldmann diplopia test, alignment test, ocular motility test, and orbital inferomedial angle ratio were the outcome measures. Results: Statistically significant improvement was observed in ocular motility, diplopia, and enophthalmos postoperatively at the 1and 6-month follow-up (p < 0.01). The mean postoperative inferomedial angle ratio (102.28 ± 10.62%) was improved significantly compared with the preoperative inferomedial angle ratio (115.61 ± 4.38%) (p = 0.004) in all patients. After surgery, inferior oblique muscle underaction was observed in seven and six patients in groups 1 and 2, respectively, which was associated with preoperative extraocular movement limitation and strabismus. Two patients showed diplopia in both groups at the last follow-up; they had inferior oblique muscle underaction but no enophthalmos. Conclusion: Orbital fracture repair with or without inferior oblique muscle reattachment was clinically effective and safe; however, patients with preoperative strabismus and extraocular motility limitation should be informed of the increased risk of postoperative complications.

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Purpose: To identify the difference between the target spherical equivalent and the postoperative spherical equivalent in trans-scleral ciliary sulcus fixation of intraocular lenses (IOLs). Methods: The medical records of patients who received trans-scleral ciliary sulcus fixation of IOLs were retrospectively analyzed. All surgeries were done by a single surgeon with a single type of IOL. The residuals of the lens material and capsule were removed by vitreous cutter under the scleral indentation, and the vitreous was also sufficiently removed. The difference between the target spherical equivalent (SE) and postoperative SE was defined as the SE difference. Cornea astigmatism and refractive astigmatism were also analyzed. Results: Fifty six eyes from 53 patients were included. The target SE was-0.430 ± 0.809 diopters (D), postoperative SE was-1.268 ± 1.267 D and the difference in SE was-0.842 ± 0.935 D. The postoperative refractive astigmatism was 1.65 ± 1.20 D. The corneal astigmatism increased from 1.01 ± 0.82 D before surgery to 1.68 ± 1.36 D after surgery (p < 0.001). Conclusions: The postoperative SE after trans-scleral ciliary sulcus fixation of IOLs tended to involve myopic shifts as much as 0.842 D compared to the target SE. Postoperative astigmatism mainly originated from corneal astigmatism rather than IOL induced astigmatism.

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