Citation

Magarakis M, Mundinger GS, Kelamis JA, Dorafshar AH, Bojovic B, Rodriguez ED. Plast. Reconstr. Surg. 2012; 129(1): 227-233.

Affiliation

Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/PRS.0b013e3182362a6d

PMID

21915081

Abstract

BACKGROUND:: Injuries to the face can potentially lead to destruction of vital structures with devastating sequelae to the patient. Facial fractures, especially of the midface, are often complicated by ocular injuries. The purpose of this study was to systematically review the literature in order to better understand specific fracture patterns associated with ocular injuries, including visual impairment and blindness. METHODS:: Pubmed, EMBASE, and Cochrane databases from January 2004 to April 2010 were systematically reviewed to identify relevant studies. Only those that investigated facial fractures with concomitant ocular injuries, visual impairment, and/or blindness were included. Studies that described non-facial fractures or those that only focused on the function of extraocular muscles were excluded. Case reports, non-systematic reviews, and studies with less than 10 patients were also excluded. RESULTS:: Eleven articles met study criteria and were included for analysis. There were a total of 14,535 patients, with an average of 1,211 (range 39 to 4,426) patients per study. Level of evidence included level II (n=1 study), III(n=2), and IV(n=9). The mean reported rate of acute visual loss was 1.7%. Periorbital and orbital blowout fractures were more often complicated by ocular injuries compared to other facial fracture patterns. High impact zygomatic fractures were most commonly associated with blindness. CONCLUSIONS:: Existing studies exploring ocular injuries, visual impairment, and blindness associated with facial fractures offer conflicting data. Specifically directed studies are required in order to draw significant correlations between specific fracture patterns and specific ocular injuries.

Language: en