{
  "abstract": "Background/Aims To ascertain factors associated with persistent diplopia after orbital fracture reconstruction.Methods In this retrospective study, we reviewed 798 cases with depressed fragment fracture at the Department of Kyoto Prefectural University of Medicine Hospital between January 2009 and November 2023. The restriction of extraocular movements and diplopia was assessed using the Hess area ratio (HAR). The factors for HAR% ≥85% before surgery and 6 months after surgery were assessed.Results Of the 798 cases in this study, 437 cases (54.8%) had an HAR% of ≥85%, and 361 cases (45.2%) had an HAR% of <85% before surgery. Age ≤18 years old (p=0.017), orbital tissue herniation volume <median (p=0.001), absence of extra-ocular muscle deviation (p<0.001) and medial wall (vs medial wall and orbital floor with strut fracture; p<0.001) were found to be associated with HAR% ≥85% before surgery. Of the 332 cases treated with surgery, 272 cases (81.9%) were HAR% ≥85%, and 60 cases (18.1%) were HAR%<85% after surgery. Age ≤18 years old (p=0.011), male (p=0.014), absence of extra-ocular muscle deviation (p=0.002) and medial wall (vs medial wall and orbital floor with strut fracture; p=0.002) were found to be associated with HAR% ≥85% at 6 months post surgery.Conclusion Patients of younger age, male and those with absence of extraocular muscle deviation have better eye movements in the affected eye (increased HAR%) 6 months after surgery.",
  "authors": [
    {
      "affiliations": [
        "Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan"
      ],
      "name": "Hiroaki Oku"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan"
      ],
      "name": "Akihide Watanabe"
    },
    {
      "affiliations": [
        "Sussex Eye Hospital, Brighton, Brighton and Hove, UK"
      ],
      "name": "Saul N Rajak"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan"
      ],
      "name": "Tomomichi Nakayama"
    },
    {
      "affiliations": [
        "Kyoto Prefectural University of Medicine, Kyoto, Japan",
        "Seirei Hamamatsu General Hospital, Hamamatsu, Japan"
      ],
      "name": "Akiko Yoneda"
    },
    {
      "affiliations": [
        "Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan"
      ],
      "name": "Kengo Yoshii"
    },
    {
      "affiliations": [
        "Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan"
      ],
      "name": "Chie Sotozono"
    }
  ],
  "title": "Factors associated with diplopia before and after orbital blowout fracture reconstruction",
  "uid": "88a50a93-0e35-56d1-9439-6583b84e5fba"
}