The surgical management of orbital fractures: a case series
Date
2013-04-08
Authors
Jugadoe, Bhavna
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Abstract
Purpose
The purpose of this research was to evaluate the outcomes, specifically diplopia and
enophthalmos, as well as the complications of surgical repair of orbital fractures using the
transconjunctival surgical approach.
Methods
A cross-sectional descriptive study was conducted. Thirty patients who underwent
surgical repair of an orbital fracture were included in this case series. All patients were
operated using the transconjunctival surgical approach and in all cases the fracture was
repaired with 0.4 mm nylon foil sheeting (Supramid). The preoperative and postoperative
clinical findings of visual acuity, diplopia and enophthalmos were analyzed, and
postoperative complications were noted. Results
Twenty-five of 30 patients (83%) presented with diplopia preoperatively and two patients
(7%) had persistent diplopia postoperatively. Enophthalmos of greater than 2mm was
present in 16 of 30 patients (53%) preoperatively and five patients (17%) had persistent
enophthalmos postoperatively. All patients with persistent postoperative diplopia and or
enophthalmos underwent late surgical repair (mean 10.6 months). Ten patients (33%) in
this series were repaired early, within three weeks of trauma, and had no diplopia or
enophthalmos postoperatively. There were no cases of lower lid retraction or ectropion.
There was one complication related to the nylon foil.
Conclusion
The transconjunctival surgical approach used to repair orbital fractures was associated
with good functional outcomes and few complications. Early surgical repair of orbital
blowout fractures and the use of nylon foil sheeting are supported by this case series.