Early versus late repair of orbital blowout fractures

Ophthalmic Surg Lasers Imaging. 2009 Mar-Apr;40(2):141-8. doi: 10.3928/15428877-20090301-05.


Background and objective: To compare early and late surgical repair of orbital blowout floor fractures.

Patients and methods: A retrospective, comparative interventional case series reviewed medical records of 50 consecutive patients who underwent unilateral orbital floor fracture repair in a 4-year period. Comparative analysis was performed between patients operated on within 2 weeks of injury and those operated on at a later stage.

Results: Assault, motor vehicle accidents, and sports injuries were the most common causes of injury. Surgery was performed due to inferior rectus muscle entrapment and limitations in up gaze in 20 (40%) patients or to prevent enophthalmos in cases with significant bony orbital expansion in 30 (60%) patients. After surgery, enophthalmos improved an average of 0.8 mm. Limitation in ocular motility improved after surgery but was statistically significant only in up gaze. Patients who underwent early repair (within 2 weeks) achieved less improvement in enophthalmos versus patients who underwent late repair (delta enophthalmos of 0.2 +/- 1.1 vs 1.3 +/- 1.9 mm, respectively; P = .02).

Conclusion: In these patients, postoperative vertical ductions and postoperative enophthalmos improved after fracture repair. Surgery was associated with a low rate of postoperative complications. No apparent difference in surgical outcome was seen between early (within 2 weeks) and late surgical repair.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Enophthalmos / physiopathology
  • Enophthalmos / prevention & control
  • Eye Movements / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ocular Motility Disorders / physiopathology
  • Oculomotor Muscles / physiopathology
  • Ophthalmologic Surgical Procedures*
  • Orbit / injuries*
  • Orbital Fractures / diagnostic imaging
  • Orbital Fractures / physiopathology
  • Orbital Fractures / surgery*
  • Retrospective Studies
  • Time Factors
  • Tomography, X-Ray Computed
  • Visual Acuity
  • Young Adult