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Existing evidence on its risk factors is based on single-institution studies and small sample sizes. Our study is the first multi-center study to develop and validate a risk calculator for the prediction of postoperative diplopia following OFR. We reviewed trauma patients who underwent OFR at two high-volume trauma centers (2015\u20132019). Excluded were patients\u2009&lt;\u200918\u00a0years old and those with postoperative follow-up\u2009&lt;\u20092\u00a0weeks. Our primary outcome was incidence\/persistence of postoperative diplopia at\u2009\u2265\u20092\u00a0weeks. A risk model for the prediction of postoperative diplopia was derived using a development dataset (70% of population) and validated using a validation dataset (remaining 30%). The C-statistic and Hosmer\u2013Lemeshow tests were used to assess the risk model accuracy. A total of <jats:italic>n<\/jats:italic>\u2009=\u2009254 adults were analyzed. The factors that predicted postoperative diplopia were: age at injury, preoperative enophthalmos, fracture size\/displacement, surgical timing, globe\/soft tissue repair, and medial wall involvement. Our predictive model had excellent discrimination (C-statistic\u2009=\u200980.4%), calibration (<jats:italic>P<\/jats:italic>\u2009=\u20090.2), and validation (C-statistic\u2009=\u200980%). Our model rules out postoperative diplopia with a 100% sensitivity and negative predictive value (NPV) for a probability\u2009&lt;\u20098.9%. Our predictive model rules out postoperative diplopia with an 87.9% sensitivity and a 95.8% NPV for a probability\u2009&lt;\u200913.4%. We designed the first validated risk calculator that can be used as a powerful screening tool to rule out postoperative diplopia following OFR in adults.<\/jats:p>","DOI":"10.1038\/s41598-024-54121-w","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T17:04:12Z","timestamp":1707843852000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Development and validation of a risk calculator for postoperative diplopia following orbital fracture repair in adults"],"prefix":"10.1038","volume":"14","author":[{"given":"Bashar","family":"Hassan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Hricz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seray","family":"Er","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Resnick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul N.","family":"Manson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Grant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"issue":"4","key":"54121_CR1","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1055\/s-0030-1269769","volume":"24","author":"FS Roth","year":"2010","unstructured":"Roth, F. 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