To explore the clinical effects of different treatment schemes for eyeball atrophy combined with orbital fractures.

47 patients (47 eyes) with ocular atrophy and orbital fractures were collected who were diagnosised in the Eye Center of Beijing Tongren Hospital affiliated to Capital Medical University from January 2017 to December 2020. Among them, there were 39 male (39 eyes) and 8 female (8 eyes) with the average age of (39.3±11.8) years (ranged from 18 to 68 years). The schemes adopted for surgical treatment were consistent with the rules. The patient′s operation plan, lesion type, implant material, diameter of implanted artificial eye table and wearing of artificial eye piece were recorded, and described by the number of cases (eyes) and percentage. The difference of bilateral exophthalmos of patients after operation for 6 months was measured and calculated, and expressed as the median and interquartile range [M(Q1, Q3)]. The patients′satisfaction with the postoperative appearance, the follow-up time and the occurrence of complications were recorded and described by the number of cases (eyes) and percentage.

All 47 patients (47 eyes) after wearing of artificial eye piece were able to adjust the difference between two sides of the eyeball protrusion to < 2 mm. By the end of the follow-up, they had all satisfied with the appearance. Among them, 19 cases (19 eyes) with simple orbital fractures without orbital fractures were only implanted with artificial eye table, accounting for 40.43%; 15 cases (15 eyes) with simple infraorbital fractures without orbital fractures were implanted with artificial eye table, accounting for 31.92%; 2 cases (2 eyes) with simple infraorbital fractures were repaired with orbital fractures and implanted with artificial eye platform, accounting for 4.26%; 7 cases (7 eyes) with orbital inner and lower wall fractures without orbital fractures repair and only implanted with artificial eye table, accounting for 14.89%; 3 cases (3 eyes) with orbital inner wall and lower wall fractures, and only were repaired with orbital lower wall fractures and implanted with artificial eye sockets, accounting for 6.38%; one case (1 eye) with orbital inner wall and lower wall fracture was repaired with orbital inner wall and lower wall and implanted with artificial eye platform, accounting for 2.13%. After the operation for 6 months, the difference of bilateral exophthalmos was 2 to 4 mm, 3 to 5 mm, 3 mm, 4 to 5 mm, 2 to 4 mm, and 4 mm, respectively; the median was 3 (2, 3) mm, 4 (3, 4) mm, 3 (3, 3) mm, 4 (4, 5) mm, 3 (2, 4) mm, and 4 (4, 4) mm, respectively. Among of 47 patients (47 eyes), 8 patients (8 eyes) were implanted with 23 mm diameter artificial eye table, accounting for 17.02%. After the operation for 6 months, the difference of bilateral exophthalmos was 3 to 5 mm, and the median was 3.5 (3, 4) mm. 39 cases (39 eyes) were implanted with 24 mm diameter artificial eye table, accounting for 82.98%. After the operation for 6 months, the difference of bilateral exophthalmos was 2 to 5 mm, and the median was 3 (3, 4) mm. 6 patients (6 eyes) with orbital fractures were repaired, accounting for 12.77%; 4 cases (4 eyes) were implanted with preforming small titanium mesh without polyethylene plate, accounting for 8.51%. After the operation for 6 months, the difference of bilateral exophthalmos was 3 to 4 mm, and the median was 3 (3, 3.75) mm. One case (1 eye) was implanted with preforming small titanium mesh and polyethylene plate, accounting for 2.13%. After the operation for 6 months, the difference between the two sides of exophthalmos was 2 mm. One case (1 eye) was implanted with preforming large titanium mesh and polyethylene plate, accounting for 2.13%. After the operation for 6 months, the difference between the two sides of exophthalmos was 4 mm. All patients′ complications were not found during the follow-up period.

According to the rules formulated in this study, the difference of bilateral exophthalmos of patients is within a reasonable range for the surgical treatment of eyeball atrophy combined with orbital fractures, and the treated patients have high gratification.