Exposure of the inferior orbit with fornix incision and lateral canthotomy

Exposure of the inferior orbit is necessary for exploration of the orbit for repair of orbital fractures, reconstruction of the orbit to correct enophthalmos with a volume implant, and decompression of the orbit to relieve the symptoms and improve appearance in cases of dysthyroid exophthalmos. The usual approach to the inferior orbit has been through a subciliary skin incision and dissection of a skin flap to the orbital rim. A technique is presented which utilizes an inferior fornix conjunctival incision combined with a lateral canthotomy and outward rotation of the lower lid. The advantages of this technique are that it avoids a lengthy skin incision with dissection which may present skin shrinkage if repeated surgery is necessary, employs a very simple closure, and provides better exposure of the nasal, inferior and lateral orbits while leaving the lower lid structures intact, preserving its integrity.