Ocular injuries in midfacial fractures.

Area of Science:

• Ophthalmology
• Trauma Surgery
• Facial Reconstruction

Background:

• Ocular lesions occur in 4-67% of midfacial fractures, with varying reported incidences.
• Midfacial fractures pose significant risks for associated ocular complications.
• Understanding these risks is crucial for effective patient management.

Purpose of the Study:

• To analyze the incidence and types of ocular lesions in patients with midfacial fractures.
• To correlate ocular damage with fracture etiology and classification.
• To identify specific fracture patterns most commonly linked to eye injuries.

Main Methods:

• Retrospective study of 219 patients (233 fractures) admitted between January 1990 and June 1994.
• Fracture classification using Henderson's system with X-ray and Computed Tomography (CT).
• Ophthalmologic evaluation excluding palpebral lesions, categorizing injuries as extraocular or intraocular.

Main Results:

• Extraocular lesions included lacrimal system damage, cranial nerve palsies, globe displacement, corneal issues, and conjunctival injuries.
• Intraocular lesions involved anterior structures (hyphema, cataract, lens dislocation) and posterior structures (hemorrhage, perforation, optic nerve damage, Berlin's edema).
• Comminuted fractures, orbital rim fractures, and orbital floor fractures showed the highest association with ocular damage.

Conclusions:

• Automobile accidents and assaults were the primary causes of these midfacial fractures with ocular involvement.
• Specific fracture types, particularly comminuted and orbital floor fractures, necessitate thorough ophthalmologic assessment.
• Prompt identification and management of ocular lesions are vital in treating midfacial trauma.