A Randomized Comparison of Four Incisions for Orbital Fractures

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Abstract
Conjunctival and subciliary incisions were previously compared for exposure of orbital floor and infraorbital rim fractures. A prospective randomized comparison of lower eyelid and orbital rim incisions was undertaken and results compared with the previous study. Lower eyelid and orbital rim incisions provided more rapid access to fracture sites. Fracture exposure was adequate with all but conjunctival incisions; lateral canthotomy was added in 56% of cases to improve exposure. There were minimal or no intraoperative and postoperative complications except for a 42% incidence of ectropion following subciliary incisions. Scar appearance was similar in the 4 groups, except when an isolated conjunctival incision was used, which produced an invisible scar.

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