Delayed immediate surgery for orbital floor fractures: Less can be more

Area of Science:

• Ophthalmology
• Trauma Surgery

Background:

• Orbital floor fractures can cause diplopia, enophthalmos, and infraorbital dysthesia.
• Immediate surgical intervention is the current standard treatment for orbital floor fractures.
• Some unoperated cases show minimal or no bothersome symptoms.

Purpose of the Study:

• To evaluate the long-term outcomes of nonoperated orbital floor fractures.
• To assess the efficacy of delayed surgical intervention for orbital floor fractures.

Main Methods:

• A retrospective study of 11 patients with orbital floor fractures who did not undergo immediate surgery.
• Late follow-up (average 945 days) to assess diplopia, enophthalmos, extraocular movements, and infraorbital dysthesia.

Main Results:

• Eight patients with initial diplopia experienced resolution of double vision.
• One patient developed asymptomatic, measurable enophthalmos (-3 mm).
• All patients achieved full restoration of extraocular movements and resolution of infraorbital dysthesia, avoiding surgical risks.

Conclusions:

• Delaying surgery for up to two weeks for orbital floor fractures may be a safe and effective approach.
• Nonoperative management can lead to favorable long-term outcomes, avoiding surgical complications.
• This approach may prevent unnecessary surgical risks and inconveniences for many patients.