Orbital Floor Reconstruction Considering Orbital Floor Slope

Abstract

Orbital floor fractures are among the more challenging injuries faced by plastic surgeons. Enophthalmos is defined as backward, usually downward, displacement of the globe into the bony orbit. We describe reconstruction of the orbital floor slope in orbital floor fractures that prevents postoperative complications, especially posttraumatic enophthalmos. Thirty-three patients with orbital floor fractures were treated using reconstruction of the orbital floor slope between April 2009 and July 2010. The patients ranged in age from 12 to 54 years. There were 31 males and 2 females. All patients were operated on using a transconjunctival approach under general anesthesia. The orbital floor was reconstructed with poly-L/D-lactide sheets in all cases. Preoperatively, 23 [Float1] patients (69%) had enophthalmos, and 12 patients (36%) had symptomatic diplopia. The enophthalmos was corrected in 20 patients (86%), and the diplopia resolved in 10 (83%). Extrinsic ocular movement was impaired preoperatively in 1 patient (3%), but resolved after surgery. No patient had impaired visual acuity preoperatively or postoperatively. The results suggest that orbital floor reconstruction considering the orbital floor slope is a safe, reliable method with fewer complications that is more effective at preventing posttraumatic enophthalmos.