Transconjunctival approach vs subciliary skin-muscle flap approach for orbital fracture repair.

OBJECTIVE

To compare the transcutaneous and transconjunctival approaches for repair of orbital rim and floor fractures.

DESIGN

We conducted a retrospective study of the occurrence of eyelid retraction following the repair of 63 orbital fracture, 27 with the subciliary skin-muscle flap approach and 36 with the transconjunctival preseptal approach.

SETTING

Academic tertiary referral medical center.

PARTICIPANTS

Fifty-nine patients underwent 63 orbital explorations.

INTERVENTIONS

Of the 27 transcutaneous explorations, 24 were done early within the first 2 weeks of injury and three were performed for correction of late posttraumatic enophthalmos. Of the 36 transconjunctival explorations, 25 were done early and 11 were performed for correction of late posttraumatic enophthalmos.

OUTCOME MEASURE

Clinically noted complications.

RESULTS

We found a 12% rate of transient ectropion and a 28% rate of permanent scleral show with the subciliary skin-muscle flap approach compared with no transient ectropion and a 3% rate of permanent scleral show with the transconjunctival approach.

CONCLUSIONS

We believe that the transconjunctival approach provides excellent exposure with less risk of postoperative eyelid retraction and ectropion.