Endoscopic Reconstruction of Isolated Orbital Floor Wall Fracture Considering Orbital Floor Slope

Purpose: To present a surgical technique for the reconstruction of the orbital floor slope in patients of isolated orbital floor fracture and to evaluate the effectiveness of this technique. Methods: The authors conducted a retrospective review of all patients who underwent reconstruction of isolated orbital floor wall fracture between June 2010 and July 2015. The authors reviewed patient demographics, degree of enophthalmos, ocular motility and diplopia test results, and surgical complications. Results: This study included 33 eyes from 33 patients. The mean time interval from trauma to surgery was 24.9 days (range, 5-360 days). The average postoperative follow-up period was 7.4 months (range, 3-28 months). The degree of enophthalmos preoperatively and 1 week, 1 month, and 3 months postoperatively was -1.55 mm (range, -3 to -0.5 mm), 0.22mm (range, -0.5 to +1.0 mm), -0.06mm (range, -1.0 to +1.0 mm), and -0.13 mm (range, -0.5 to +0.5 mm), respectively. The mean improvement in enophthalmos at postoperative 3 months was 1.41mm compared with that in the preoperative data (P value < 0.001). There were no patients with residual enophthalmos greater than 1 mm after reconstruction. Conclusion: Endoscopic orbital floor slope reconstruction in isolated orbital floor wall fracture using a layered porous polyethylene barrier implant is a very useful surgical technique for safely identifying the posterior margin of a fracture and easily reconstructing the orbital floor slope. The demonstration of slight exophthalmos of the corrected side about 1 to 2 mm at the end of the operation was also necessary.