Correlation Between the Change in Orbital Volume and Correction of Enophtlamous in Delayed Post-Traumatic Cases

Abstract

Background: Post-traumatic enophthalmos is a multifactorial phenomenon that can be attributed to the increased orbital volume, loss of ligamental support of the globe or atrophy of orbital fat. Early restoration of orbital volume has been associated with an improvement in the maximal corneal projection and reduced enophthalmos. However, delayed repair of orbital fractures is more complicated due to the evident scarring of periorbital tissues. Aim of the study: The aim of this study was to correlate post-operative correction of the corneal projection to the degree of correction (decrease) of the orbital volume after delayed repair of orbital fractures. Patients and Methods: Ten patients suffering from unilateral orbital fracture who were treated one month or more from the date of trauma were included in this study. All patients received a preoperative CT that was imported into a surgical planning software to quantify the preoperative orbital volume as well as the maximal corneal projection of the traumatized orbit. One-month postoperatively, the patients received another CT scan to once again quantify the reconstructed orbital volume and to record any improvement in the maximal corneal projection. Results were recorded in the form of means ± standard deviation and Pearson's correlation coefficient was implemented to analyze the correlation between the change in the orbital volume and the change in the degree of enophthalmos. Results: The mean decrease in the orbital volume was 4.27cm 3 ± 3.60 while the mean increase in corneal projection was 2.24mm ± 1.16. Statistical analysis revealed a strong positive correlation between the forward translation of the maximal corneal projection and the change (decrease) in the orbital volume following reconstruction with a correlation coefficient (R) value of 0.82 which indicated strong correlation. The value of R 2 , the coefficient of determination is 0.67. The P value was 0.0125 which was significant at levels < 0.05. Conclusions: From the current study, it can be concluded that even in delayed cases the accurate reconstruction of the bony walls resulting in a decrease in the orbital volume is an important factor in correcting post-traumatic enophthlamos, as both variables showed a strong correlation to each other.