Lower Eyelid Malposition Following Orbital Fracture Surgery: A Retrospective Analysis Based on 198 Surgeries.

The aim of this study is to analyze the development of lower eyelid malposition following reconstruction of orbital fractures, in relation to the incisions used for access. A total of 198 surgical orbital floor reconstructions were performed in 175 patients between 2001 and 2011. Preoperative and postoperative presence of lower eyelid malposition of patients was reported. The types of incision used for access were as follows: approach via laceration (4.5%), via preexisting scar (16.2%), infraorbital (40.9%), subciliar (23.7%), transconjunctival (13.1%), and transconjunctival with lateral canthotomy (1.5%). The incidence of ectropion development following surgery was 3.0% and the incidence of entropion development following surgery was 1.0%. The highest rate of ectropion (11.1%) was seen using an approach via a laceration, followed by approach via a scar (6.3%). Our conclusion is that the transconjunctival incision without a lateral canthotomy has a low complication rate, provides adequate exposure, and leaves no visible scar.

Morbidity of harvesting the iliac crest inner cortical plate for orbital reconstruction.

PURPOSE: To evaluate the morbidity associated with harvesting the inner cortical plate of the iliac crest for reconstruction of the orbit. PATIENTS AND METHODS: In a retrospective case series study, the medical records of all patients who had undergone orbital reconstruction with bone from the iliac crest from January 2000 to April 2012 at the Erasmus Medical Centre were reviewed. A standardized surgical procedure for harvesting the inner cortical plate of the iliac crest was used for all patients. Gender, age at surgery, reconstruction type, donor site morbidity, and complications were assessed. RESULTS: The medical records of 142 patients were reviewed. Six patients were excluded because of incomplete data. Thus, a total of 136 patients (91 males and 45 females) were included in the present study, and they underwent a total of 151 procedures to harvest the inner cortical plate of the iliac crest. Seven patients (4.6%) complained of pain lasting more than 2 weeks. In 6 of them, the pain had subsided within the next few weeks. Temporary sensibility disturbance was reported by 2 patients (1.3%), hematomas occurred in 2 patients (1.3%), and no wound infections developed. CONCLUSIONS: The data from the present study have shown that when the inner cortical plate of the iliac crest is harvested for orbital reconstruction, the morbidity will be temporary in all cases.