A Retrospective Analysis of 104 Patients with Orbital Floor Reconstruction

Aims: The aim of our study was to evaluate retrospectively the results of different surgical approaches in orbital floor reconstruction between January 2001 and November 2005 at our clinic.

Material and Methods: We reviewed the charts of 104 patients and a telephone questionnaire to analyze the surgical access, pre- and postoperative complaints, time from trauma to surgery, and wound healing.

Results: Our results show that 64% of patients had isolated fractures of the orbital floor in combination with a contusion of the ocular bulb. Orbital floor exploration was performed in patients with persisting diplopia (62%) and/or paresthesia of the maxillary nerve (71%). Seventy-eight percent of the patients underwent surgical therapy within 10 days after trauma. The surgical approach was carried out by a subciliary (35%), subtarsally (53%), or transconjunctival (8%) incision. In 86% of the cases, a perforated PDS-foil was used for stabilization. After a follow-up period of 4 to 60 weeks, 12% of the patients still complained about residual diplopia and 18% about paresthesia, independent of the time between trauma and surgery. An ectropion as one possible complication was detected in < 5% of the cases without any correlation to the surgical approach. Eighty percent of the patients showed an almost invisible scar.

Conclusions: There were no significant differences in therapeutic success concerning these surgical aproaches and the time between surgery and trauma. PDS-foil, easy to handle and bioresorptive, is very effective in orbital floor reconstruction.