Outcomes analysis of eyelid deformities using photograph-assisted standardized anthropometry in 311 patients after orbital fracture treatment

Abstract

Before undergoing repair of orbital fractures, most patients are worried about their postoperative appearance. Furthermore, there is an ongoing discussion in the literature about the influence of trauma and surgical approach to the inferior orbita on eyelid deformities. In this retrospective comparative study, we present an evaluation of a series of 311 postoperative results of orbital fractures on standardized photographs based on reference anthropometric data. Analysis included eye fissure width and height, lid sulcus height, upper lid height, upper and lower iris coverage, position of cornea to inferior palpebra, canthal tilt, scleral show, ectropion, and entropion. It was clearly differentiated between operated and contralateral eyelid type of fracture of the midface and whether a transconjunctival or a subciliary approach was used. Surgery and the chosen approach presented significant effects on eye fissure index, lower iris coverage, scleral show, and ectropion. Different types of fractures affecting the orbita showed no influence on the investigated values. Not surprisingly, an association between surgery and lower lid retraction was found. The underlying osseous trauma did not show a significant influence on the presented measurements. Subciliary approaches increased the risk of lower lid retraction. The standard measurements described here are accurate and objective to evaluate postoperative results. Prognostic/epidemiologic study, level III.