Relation between Preoperative Orbital Morphology and Long-Term Ophthalmologic Outcome Up to 15 Years of Age in Unicoronal Synostosis.

IF 3.4 2区医学 Q1 SURGERY

Plastic and reconstructive surgery Pub Date : 2025-10-01 Epub Date: 2025-02-24 DOI:10.1097/PRS.0000000000012051

Hanna Lif, Romain Touzé, Johan Vegelius, Evangelia Ntoula, Giovanna Paternoster, Eva Larsson, Roman Khonsari, Daniel Nowinski

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引用次数: 0

Abstract

Background: Long-term ophthalmologic manifestations constitute the main functional issue in unicoronal synostosis, with large interindividual variability. The relation between preoperative orbital morphology and long-term functional outcome is not fully understood.

Methods: In this retrospective cohort study, patients with nonsyndromic unicoronal synostosis treated with fronto-orbital advancement and remodeling (FOAR) between 2014 and 2023 at Necker Hospital, Paris, France, or Uppsala University Hospital, Sweden, were included and paired with controls. Preoperative computed tomography (CT) and all ophthalmologic follow-up examinations 1 year or later after surgery were included. Objective 3-dimensional measurements on CT scans were used to analyze symmetry and local and global shape differences. The degree of severity in preoperative orbital morphology was correlated to long-term outcomes of oculomotor disorders, amblyopia, anisometropia, and astigmatism.

Results: Thirty-six patients and 36 controls were included. The mean ages were 8.5 ± 7 months (range, 0.3 to 34 months) at CT examination, 12 ± 7 months (range, 8 to 36 months) at FOAR, and 6 ± 3 years (range, 2 to 15 years) at last ophthalmologic examination. Ipsilateral large global shape deformity of the orbit was related to strabismus (vertical strabismus in particular) and pseudotrochlear palsy at long-term follow-up. Neither preoperative contralateral morphology nor age at FOAR was associated with ophthalmologic outcomes.

Conclusions: Ipsilateral oculomotor disorders at follow-up correlate with the degree of global orbital deformity primarily caused by the synostosis, suggesting that preoperative ipsilateral morphology might constitute a predictive factor for poor ophthalmologic outcome, whereas neither age at FOAR nor contralateral morphology influenced long-term ophthalmologic outcome. FOAR does not seem to prevent or reduce strabismus.

Clinical question/level of evidence: Risk, II.

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单冠状突眼患者术前眼眶形态与 15 岁前长期眼科治疗效果的关系。

背景：长期眼科表现是独冠状关节闭锁（UCS）的主要功能问题，具有很大的个体差异。术前眼眶形态与远期功能预后的关系尚不完全清楚。方法：在这项回顾性队列研究中，纳入了2014 - 2023年间在法国巴黎Necker医院或瑞典乌普萨拉大学医院接受前眶推进和重塑（FOAR）治疗的无综合征UCS患者，并与对照组配对。术前计算机断层扫描（CT）和术后≥1年的所有眼科随访检查。目的利用CT扫描的三维测量来分析对称性、局部和全局形状差异。术前眼窝形态的严重程度与眼部运动障碍、弱视、屈光参差和散光的长期预后相关。结果：纳入36例患者和36例对照组。CT检查平均年龄为8.5±7（0.3 ~ 34）个月，FOAR检查平均年龄为12±7（8 ~ 36）个月，最后一次眼科检查平均年龄为6±3（2 ~ 15）岁。同侧，与斜视，尤其是垂直斜视，以及假性滑车性麻痹相关的眶大整体形状畸形。术前对侧形态学和FOAR的年龄与眼科预后无关。结论：随访时的同侧眼肌运动障碍与主要由结膜紧闭引起的全眶畸形程度相关，提示术前同侧形态学可能是不良眼科预后的预测因素，而FOAR的年龄和对侧形态学都不影响长期的眼科预后。FOAR似乎不能预防或减少斜视。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Plastic and reconstructive surgery 医学-外科

CiteScore

5.00

自引率

13.90%

发文量

1436

审稿时长

1.5 months

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