Comparison of Treatment Outcomes Between Early and Delayed Primary Repair of Orbital Blowout Fractures: A...

To compare clinical outcomes between early (≤4 wk) and late (≥4 wk) surgical repair of orbital blowout fractures (BOF) in adults.

A retrospective review was conducted on 172 adults undergoing primary orbital BOF repair. Patients were categorized into early (n=123) and late (n=49) repair groups. Preoperative and postoperative outcomes were compared, including extraocular muscle (EOM) motility, enophthalmos, diplopia, infraorbital hypesthesia, operative time, and complications.

Preoperative assessments revealed that patients in the early repair group exhibited worse EOM motility (-0.93 versus -0.49; P=0.005), whereas those in the late repair group presented with greater enophthalmos (1.77 versus 1.33 mm; P=0.006). Both groups demonstrated significant postoperative improvements, resulting in similar final outcomes for EOM motility (-0.12 versus -0.04; P=0.164) and enophthalmos (0.23 mm versus 0.23 mm; P>0.999). Residual diplopia resolved in all patients by 12 months (mean recovery: 64.57 versus 64.65 d; P=0.997). Infraorbital hypesthesia rates (1.6% versus 2.0%; P=0.851) and recovery times (74.00 versus 69.50 d; P=0.882) were comparable between groups. There were no significant differences in operative time (46.54 versus 46.45 min; P=0.984) or incidence of complications-including new diplopia, sensory deficits, or haematoma-between early and delayed repair.

Delayed BOF repair conducted after 4 weeks achieved equivalent functional, cosmetic, and neurosensory outcomes compared with early intervention, with no increase in operative risks. Delayed repair remains a viable and effective option for patients presenting with persistent diplopia or late-onset enophthalmos.