Surgical Repair of Orbital Blow-Out Fractures: Outcomes and Complications

Abstract

Objectives: The purpose of this study is to evaluate the demographics of patients with orbital blow-out fractures, as well as the success and complications of surgical repair with porous polyethylene membrane sheet implants through transconjunctival technique and to compare the results to previously published studies. Methods: This retrospective study included 57 patients diagnosed with orbital blow-out fractures referred to our clinic between 2018 and 2022. Seventeen patients (29.8%) underwent orbital fracture repair through a transconjunctival technique employing porous polyethylene membrane sheets. The indications for surgery were enophthalmos >2 mm and persistent ocular motility restriction, diplopia, and strabismus. The success criteria were <2 mm of enophthalmos and complete correction of eye motility, diplopia, and strabismus. Results: The study group consisted of ten females and 47 males with a mean age of 31.12 years. The most common cause of injury was assaults (50.9%), followed by falls (38.6%), traffic accidents (5.3%), and accidental impacts (5.3%). The inferior wall (61.4%) was the most common fracture site, followed by the medial wall (21.1%) and a combination of the inferior and medial walls (21.1%). The surgically treated group showed a significant improvement in ocular motility restriction (88.2–23.5%, p=0.002), diplopia (70.6–23.5%, p=0.008), and enophthalmos (1.41 mm to 0.82 mm, p=0.012) after surgery. The surgery was successful in ten of 17 cases (58.8%), and the success rate was higher in patients who were treated early (77.8% vs. 37.5%), but the difference was not statistically significant (p=0.092). Conclusion: Orbital blow-out fracture repair using porous polyethylene membrane sheets through a transconjunctival approach is a safe and effective surgical technique for orbital blow-out fracture repair. Although patients who had early surgery had a higher success rate in our study group, larger study groups are needed to assess the effect of surgical timing on success.