Upper lid transconjunctival versus transcutaneous approach for fracture repair of the lateral orbital rim.

The use of the lower eyelid transconjunctival approach in the setting of orbital trauma has becoming increasingly popular in recent years. However, experience has found that access to the lateral orbital rim can be somewhat limited with this type of incision. Many authors supplement the approach with a lateral canthotomy in order to gain adequate access laterally. Although usually well tolerated, there can be side effects associated with this incision. We examine the upper lid transconjunctival approach to the lateral orbital rim. Furthermore, we compare this technique to the more traditional transcutaneous approaches used for orbital trauma. We have found this technique to be safe, effective, and to cause no more complications than the more traditional approaches.