Lower incidence of chemosis with the Berke incision approach versus the swinging eyelid approach after deep lateral orbital wall decompression.

PURPOSE

To compare the incidence of chemosis following deep lateral orbital wall decompression using the Berke incision approach vs the swinging eyelid approach.

METHODS

This study retrospectively reviewed 49 sides in 29 patients who underwent decompression via the Berke incision approach (Group A) and 122 sides in 71 patients who underwent decompression via the swinging eyelid approach (Group B).

RESULTS

The incidence of chemosis was significantly lower in Group A (30.6%) compared with Group B (48.4%; p = 0.034). Although the period until subsidence of chemosis did not differ between the groups (p = 0.164), the ratio of sides that needed intensive postoperative care was lower in Group A than in Group B (p = 0.002). Chemosis tended to occur more frequently in sides with a history of steroid administration relative to those without previous steroid administration (Group A, p = 0.042; Group B, p = 0.059), although past radiation therapy and past combined radiation and steroid therapy did not influence the occurrence of chemosis (p > 0.050). Postoperative proptosis reduction was similar in both groups (p = 0.087).

CONCLUSION

It was found that the Berke incision approach yielded a lower incidence of chemosis while achieving similar postoperative proptosis reduction in comparison with the swinging eyelid approach. These findings suggest that the Berke incision approach is an acceptable alternative procedure for deep lateral orbital wall decompression.