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Updated: Apr 23, 2026

Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Changes in Intraocular Pressure During Orbital Floor Fracture Repair
Preeti J Thyparampil1, Benjamin C Campbell, Phillip N Freeman
1*Department of Ophthalmology, Alkek Eye Center, Baylor College of Medicine; †Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center, Houston, Texas; ‡Department of Ophthalmology, Casey Eye Institute, Oregon Health and Sciences University, Portland, Oregon; and §Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, Gavin Herbert Eye Institute, University of California, Irvine, California, U.S.A.
Purpose:
To evaluate changes in intraocular pressure (IOP) during orbital floor fracture repair.
Methods:
Retrospective chart review of patients undergoing isolated orbital floor fracture repair with implant placement at a level 1 trauma center and tertiary care center. Patients with combined zygomaticomaxillary or medial wall fracture repair, or other significant ocular injuries were excluded. IOP measurements using a handheld applanation tonometer were recorded immediately after induction of anesthesia, immediately after orbital floor implant placement, and on postoperative day 1.
Results:
Nine patients who underwent isolated orbital floor fracture repair were examined. There was a statistically significant mean decrease of 4.66 mmHg (p < 0.05) in IOP from prior to surgical to immediately after implant placement. There was also a significant mean increase in IOP of 7.44 mmHg (p < 0.05) at postoperative day 1 compared with immediately after implant placement. There was no statistically significant difference in IOP between prior to surgical incision and postoperative day 1.
Conclusions:
All patients who underwent orbital floor fracture repair in this study had a significant decrease in IOP during orbital floor fracture repair that returned to immediately preoperative levels by postoperative day 1. This initial decrease in IOP may be because of intraoperative manipulation of the globe.
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