Perforating the polydioxanone sheet: avoiding intraorbital hematoma after open treatment of orbital floor fractures

The surgical treatment of orbital floor fracture, a common facial injury, is not a risk-free procedure. Complications after orbital surgery can include infection, implant migration, mydriasis, epiphora, persistent diplopia, enophthalmos, infraorbital numbness, retrobulbar hemorrhage, and blindness. Blindness has been ascribed to retrobulbar hematoma in almost 50% of cases. In our experience, blood collection above the polydioxanone sheet after the treatment of orbital floor fracture can be caused by the tight adhesion of the sheet to the bony edges of the fracture. Here, we present a simple procedure to avoid this potentially dangerous complication.