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Special Communication
Jul/Aug 2014

Avoiding Complications in the Repair of Orbital Floor Fractures

Author Affiliations
  • 1Section of Orbital and Ophthalmic Plastic Surgery, Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin
JAMA Facial Plast Surg. 2014;16(4):290-295. doi:10.1001/jamafacial.2014.56

Fractures of the orbital floor are commonly repaired by all specialists who manage facial trauma. Potential complications include incomplete correction of preoperative enophthalmos or diplopia, as well as induction of hypoglobus or hyperglobus, eyelid malposition, or optic nerve injury. To optimize functional and aesthetic results, a stepwise analysis of the surgical procedure is presented—from the election and timing of repair, through the incision and dissection path, release of herniated orbital tissue, implant material and placement, wound closure, and postoperative care. Key elements include the distinction of floor fracture subtypes, avoiding cicatricial contraction of the lower eyelid, complete release of herniated soft tissue, direct observation of all fracture margins, and proper contouring and positioning of the implant.