An unobstructed view of the operative field is essential in orbital surgery. However, surgical exposure is often impaired by the orbital fat that billows forth when the periorbita has been opened. Broad-tipped malleable retractors, in use at least as early as Berke's1 modification of the Krönlein2 procedure, continue to be standard instrumentation for deep orbital surgery. Unfortunately, broad retractors hold back the anterior fat but cannot extend into the narrow orbital apex. Ribbon retractors that are narrow enough to reach the apex permit the fat to bulge around their sides.
A simple modification of standard malleable ribbon retractors accommodates the triangular shape of the orbital walls (Figure 1). The tapered distal ends allow exposure of the narrow orbital apex, while the wider proximal portions retract the orbital fat and other soft tissues (Figure 2).
These retractors have facilitated our orbital surgery for the last 3 years. They have
Harris GJ, Deans RM, Murphy ML. Tapered Orbital Retractors. Arch Ophthalmol. 1995;113(12):1580. doi:10.1001/archopht.1995.01100120112031