Orbital fractures: eyelid approach.

Orbital floor fractures can be explored through the eyelid with a subciliary or a smile-crease incision. A two-plane incision is made to expose the orbital rim. Orbital contents are removed from the sinus, and an alloplastic implant is used to cover the fracture. The periosteum is closed over the implant. Fine suture material is used to close the skin. These approaches give good exposure of the orbital floor and excellent postoperative cosmesis.