Hess Area Ratio and Diplopia: Evaluation of 30 Patients Undergoing Surgical Repair for Orbital Blow-Out Fracture.
Grenga, Pier Luigi M.D. *; Reale, Gabriele M.D. +; Cofone, Carmela M.D. *; Meduri, Alessandro M.D. ++; Ceruti, Piero M.D. [S]; Grenga, Roberto M.D. *
Ophthalmic Plastic & Reconstructive Surgery.
25(2):123-125, March/April 2009.
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Purpose: To determine if the Hess area ratio is effective in predicting postoperative diplopia in patients undergoing surgery for orbital blow-out fracture.
Methods: Our retrospective, interventional case series study involved 30 consecutive cases affected by orbital fractures and diplopia undergoing surgical correction within 7 days after injury. To evaluate ocular motility disturbance, we measured the involved ocular motility range by use of a manual Hess screen test before and 4 months after surgery. The percentage of Hess area ratio % was used to express the range of ocular motility in a numerical value.
Results: All patients with preoperative Hess area ratio >85% had no postoperative diplopia, and most patients (57%) having a preoperative Hess area ratio <65% had postoperative diplopia. When the Hess area ratio was between 65% and 85%, surgical outcomes were variable and most patients (55%) described no problematic diplopia in the peripheral visual field.
Conclusions: The Hess area ratio is a useful procedure to convert Hess graphic representation in a numerical value so that Hess chart data can be compared among clinicians and used to predict surgical outcomes in patients undergoing surgery for orbital blow-out fractures.
(C)2009The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.