The subtarsal incision: where should it be placed?

Area of Science:

• Ophthalmology
• Plastic Surgery
• Facial Trauma Reconstruction

Background:

• The subtarsal incision is a common surgical approach for orbital floor fractures.
• It offers benefits over subciliary and transconjunctival incisions, including reduced lower lid retraction and no need for lateral canthoplasty.
• However, the precise placement of the subtarsal incision varies among surgeons.

Purpose of the Study:

• To determine the optimal placement of the subtarsal incision for orbital floor fractures.
• To evaluate the correlation between incision placement and scar visibility.

Main Methods:

• Twenty patients with orbital floor fractures underwent surgery using the subtarsal incision.
• Postoperative scar visibility was assessed by medical and non-medical personnel for the first seven patients.
• Pearson correlation coefficients were calculated to analyze the relationship between scar location and visibility.

Main Results:

• No major complications like lower lid retraction or enophthalmos were observed.
• A transient facial palsy occurred in one patient.
• A positive correlation was found between the distance from the lash line to the scar and scar visibility.

Conclusions:

• The ideal subtarsal incision placement is as close as possible to the inferior border of the tarsal plate.
• Placing the incision within a natural skin crease is recommended.
• Inferior placement improves fracture visualization but increases scar visibility.