The Revised Direct Transconjunctival Approach to the Orbital Floor

Area of Science:

• Ophthalmology
• Plastic Surgery
• Trauma Surgery

Background:

• Surgical management of orbital floor defects requires adequate exposure.
• Traditional approaches often involve lateral canthotomy and inferior cantholysis, potentially leading to complications.

Purpose of the Study:

• To review surgical approaches to the orbital floor.
• To evaluate the efficacy of a canthal-sparing, single-incision transconjunctival method.

Main Methods:

• Retrospective chart review of patients undergoing transconjunctival surgery without eyelid dissection or lateral canthotomy.
• Literature review of orbital floor surgical techniques.

Main Results:

• Twenty-three patients (33 orbits) were treated with the canthal-sparing approach.
• Adequate surgical exposure was achieved for orbital floor fractures, implant removal, enophthalmos repair, and decompressions.
• No complications were observed during a mean follow-up of 13 months.

Conclusions:

• The canthal-sparing transconjunctival approach provides rapid, effective access to the orbital floor and inferior orbital rim.
• This technique minimizes lower eyelid dissection and spares the lateral canthus.
• It is a valuable method for managing orbital floor fractures, enophthalmos, and other orbital pathologies, even in pediatric cases.