Surgical treatment of posttraumatic enophthalmos: a study of 72 patients

The present article deals with the surgical experience of treating 72 patients for posttraumatic enophthalmos. Patients were divided into the following 4 groups with respect to the type of injury and the time of surgery: Group 1, recent midfacial injuries with orbital floor fractures; Group 2, recent blow-out fractures; Group 3, neglected blow-out fractures; and Group 4, neglected fractures of the zygoma or the zygomatic-maxillary complex. Osteoplasty of the floor of the orbit was performed in all groups with bone or cartilage grafts such as lamina from the anterior maxillary wall, iliac and calvarial graft as well as rib cartilage. In addition to osteoplasty, reposition and fixation of fractured bones as well as refracture of malunited zygomatic-maxillary complex were performed in patients in Groups 1 and 4, respectively. Enophthalmos was recorded in 5 and 2 of 20 patients from Groups 1 and 2, respectively. In Group 3, enophthalmos was corrected in 3 of 7 patients, whereas 16 patients were corrected of 25 from Group 4. Advantages and disadvantages of applied surgical techniques are discussed and personal observations emphasized.