Blowout Fracture Research Articles

Technical considerations of computer-aided planning in severe orbital trauma: A retrospective study

The aim of this study was to evaluate the clinical outcomes of linear and orbital volume measurements in severe orbital trauma. Patients with severe orbital trauma that involved more than two walls and entailed a marked degree of comminution were included in this retrospective analysis. However, patients with incomplete clinical records and a simple blowout or zygmatico-orbital fractures were excluded. All the cases underwent surgical correction guided by virtual surgical planning and 3D-printed templates. The measurement protocol depended on assessing orbital dimensions, orbital volumetry, and the zygomatic bone's position in the three-dimensional planes. All patients' preoperative 3D CT scans were obtained, and DICOM files were imported into a three-dimensional image processing software. Data were then converted for 3D reconstruction in the axial, coronal, and sagittal views. A total of 18 patients with a mean age was 39.28 ± 6.28 were included in this study. The results revealed a significant difference between the pre and postoperative differences in distances in relation to the FHP (Frankfurt Horizontal Plane) (P = 0.0014) and sagittal planes (P < 0.0001). The orbital width and height of the traumatized orbit were significantly decreased from 45.26 ± 6.72 mm and 45.30 ± 2.89 mm to 39.74 ± 3.91 mm (P = 0.0022), and 40.34 ± 0.86 mm (P < 0.0001), respectively. Clinically, there was a satisfactory degree of symmetry regarding the zygomatic bones' position and orbital dimensions postoperatively. Moreover, the mean orbital volume on the traumatized side decreased significantly from 23.16 ± 1.91 cm3 preoperatively to 20.7 ± 1.96 cm3 postoperatively (P < 0.0001). These findings were associated with a low incidence of complications. Within the limitations of the study it seems that the described methodology is a relevant addition to clinical treatment options. It incorporates all the latest technology to plan virtual reconstruction surgery in the treatment of complex orbital trauma and should be adapted accordingly in cases of severe displacement and comminution.

Clinical Results According to Inferior Oblique Manipulation in Patients with Inferomedial Blowout Fracture Involving the Orbital Strut.

Detachment of the inferior oblique muscle may be necessary under certain circumstances to repair a large inferomedial orbital fracture involving the orbital strut. This study aimed to evaluate the outcomes of patients who underwent surgeries with and without inferior oblique muscle reattachment after its detachment to repair the orbital wall fractures. Forty patients who underwent repair of combined floor and medial orbital wall fracture involving the orbital strut at a single tertiary institution between January 2014 and December 2020 were reviewed. Groups 1 and 2 comprised 20 patients each, who underwent surgery with inferior oblique muscle detachment without and with reattachment, respectively, and were followed up for at least 6 months postoperatively. Enophthalmos, Goldmann diplopia test, alignment test, ocular motility test, and orbital inferomedial angle ratio were the outcome measures. Statistically significant improvement was observed in ocular motility, diplopia, and enophthalmos postoperatively at the 1- and 6-month follow-up (p < 0.01). The mean postoperative inferomedial angle ratio (102.28 ± 10.62%) was improved significantly compared with the preoperative inferomedial angle ratio (115.61 ± 4.38%) (p = 0.004) in all patients. After surgery, inferior oblique muscle underaction was observed in seven and six patients in groups 1 and 2, respectively, which was associated with preoperative extraocular movement limitation and strabismus. Two patients showed diplopia in both groups at the last follow-up; they had inferior oblique muscle underaction but no enophthalmos. Orbital fracture repair with or without inferior oblique muscle reattachment was clinically effective and safe; however, patients with preoperative strabismus and extraocular motility limitation should be informed of the increased risk of postoperative complications.

Retrobulbar Hematoma after an open reduction of blow-out fracture of orbit

62 years old male patient who presented blunt trauma in his right eye with subsequent orbital fracture type impure blow-out who required open reduction of the facial fracture, who presented at the second postoperative day a retrobulbar hematoma with need for surgical intervention of urgency.

Blow-Up Fracture With Concussion in a Division I Collegiate Female Soccer Player

The purpose of this case report is to present the case of a Division I collegiate female soccer player diagnosed with a blow-up fracture and a concussion. This athlete suffered from a blow-up fracture, a fracture of the superior orbital rim, which is less common than the inferior, blowout fracture. The uniqueness comes from a common mechanism, player-to-player contact, causing an uncommon fracture pattern and the athlete’s full, unrestricted, return to sport. Severity of these injuries can vary from very mild to very severe, and the treatment options are variable depending on the severity.

The Impact of the COVID-19 Pandemic on Emergency Department Visits Resulting in Ophthalmology Consultations.

Introduction The aim of this study is to determine the characteristics of eye-related emergency department (ED) visits resulting in ophthalmology consultation during the COVID-19 pandemic and compare them against an equivalent period from the previous year. Methods In this study, we reviewed the charts of patients who were admitted to ED with ocular complaints between March 11th, 2020 (the date of the first COVID-positive case in our country) and March 11th, 2021 (Study period 1; SP1) and those who were admitted to ED within the equivalent period of the previous year (Study period 2; SP2). The frequency of eye-related cases, the urgency status of complaints, diagnosis, treatment applied, and hospitalization status of the patients were compared. Results The proportion of ophthalmology consultations among all medical departments decreased from 4.52% to 4.04% (p<0.001). There was a 40.5% reduction in eye-related ED admissions during the pandemic, and the top three ocular diagnoses were foreign bodies of the ocular surface (24.3%), corneal abrasion (18.7%), and blow-out fractures (6.2%) during SP1. The proportion of urgent eye-related emergency visits increased during the pandemic year (80.7% of total cases) compared to the year prior to the pandemic (66.0% of total cases) (p<0.001). Although the number of ophthalmology consultations per day decreased during lockdown periods, this decrease was not statistically significant. Conclusion During the first year of the COVID-19 pandemic, the number of eye-related ED visits decreased in comparison to the year which preceded the pandemic. However, the proportion of urgent visits increased during the pandemic. Understanding the circumstances under which patients seek eye care in EDs is critical to rendering the optimal level of service of available resources.

Rhinovirus-induced anti-viral interferon secretion is not deficient and not delayed in sinonasal epithelial cells of patients with chronic rhinosinusitis with nasal polyp.

Dysregulated innate and adaptive immune response to rhinoviral infection plays an important role in the exacerbation or progressive course of chronic rhinosinusitis (CRS). However, few studies have evaluated whether rhinovirus-induced production of anti-viral interferon is deficient or delayed in inflammatory epithelial cells of patients with CRS with nasal polyps. The aim of the present study is to investigate the replication rates of rhinovirus 16 (RV 16), RV16-induced antiviral interferon secretion, and the expression levels of pattern recognition receptors after RV 16 infection or TLR3 stimulation with poly (I: C) in normal and inflammatory epithelial cells. Inflammatory epithelial cells were obtained from CRS patients with nasal polyps and normal epithelial cells were derived from ethmoid sinus mucosa during endoscopic reduction of blowout fracture or uncinate process mucosa of patients with septal deviation. Cultured cells were infected with RV 16 or treated with poly (I: C) for 24, 48, and 72h. Cells and media were harvested at each time point and used to evaluate RV16 replication rates, the secretion of IFN-β, -λ1, -λ2, viperin, Mx, and OAS, and the expression levels of TRL3, RIG-I, MDA5, phospho-NFκB, and phospho-IRF3. RV replication rates reached peak levels 48h after inoculation in both normal and inflammatory epithelial cells and showed no difference between both groups of epithelial cells at any time point. The release of IFN-β, -λ1, and -λ2 in normal and inflammatory epithelial cells was also strongly induced 48h after RV16 inoculation but reached peak levels 24h after poly (I: C) treatment. The expression levels of viperin, Mx, OAS, TLR3, RIG-I, MDA5, phospho-NFκB, and phospho-IRF3 showed similar patterns in both groups of epithelial cells. These results suggest that the production of RV16-induced antiviral interferons is not deficient or delayed in inflammatory epithelial cells from CRS patients with nasal polyps.

Limited eye movement caused by clumping of fibrin glue used in blowout fracture surgery: a care report

Fibrin glue is a topical agent widely used for hemostasis, wound healing, and surgical adhesion. Complications of fibrin glue itself are extremely rare because it is absorbed over time, but can occur as a result of inappropriate application. We report a case of a postoperative complication caused by inappropriate application of fibrin glue in blow-out fracture surgery. A 65-year-old male patient presented with periorbital swelling and an open wound on the right infraorbital area. Computed tomography showed a right orbital floor fracture. After reduction of the herniated tissue into the orbit, an implant was inserted and fibrin glue was applied to stabilize the implant. This procedure was performed without difficulty, but the patient complained of persistent diplopia and limited eyeball movement after surgery. An imaging study showed a mass-like lesion, which was not a hematoma, in the orbital cavity. In a second operation, the mass was identified as clotted fibrin glue that had not been applied properly. After removal, the patient's symptoms were relieved without further complications. Appropriate and careful application of fibrin glue is necessary to avoid unnecessary complications.

The Orbital Bones Protect the Globe From Sharp Periorbital Trauma Injuries.

The bones of the orbit hold the globe and periocular structures and protect it and other periocular contents. This has been shown in blowout orbital fractures, as well as in high-energy injuries to the periorbital region. However, there is little information regarding how the orbital bones protect the globe after periorbital trauma from sharp objects. This study reports 4 cases of traumatic injury from sharp objects to the periorbital area and eyelids to demonstrate the protective features of the orbital bones. The anatomy of the periorbital bones clearly protected the globe from direct trauma in all the 4 cases. There was no harm to the orbit or visual impairment after the successful treatment with definitive surgery.

Orbital Soft Tissue Displacement After Blow-Out Fracture Repair Using Poly (L-Lactide-Co-Glycolide) Polymer Plates Based on Image Fusion Technique.

To analyze the displacement of orbital soft tissue after blow-out fracture (BOF) repair with poly (L-lactide-co-glycolide) plates. In this retrospective study, all patients who had undergone repair operations for orbital BOF from 2017 to 2021 were evaluated. Poly (L-lactide-co-glycolide) plates were used as repair materials. Preoperative and postoperative computed tomography images were integrated into the same coordinate system applying image fusion technique and were compared to determine the maximum displacement of orbital tissue after surgical repair. A total of 15 patients were included. Five were male, and 10 were female. Mean age was 33±16 years. Median waiting period was 18 (12-23) days. Six cases were medial wall fractures, 5 were floor fractures, and 4 were combined fractures. Maxillo-ethmoidal strut was involved in 4. Mean defect area was 176.52±108.48mm 2 . Median interval between postoperative imaging examinations was 292 (223-600) days. Mean orbital tissue displacement was 2.6±1.8mm. Using simple and multivariable linear regression analysis, the fracture defect area ( P =0.001) and maxillo-ethmoidal strut involvement ( P =0.013) were found to be significantly associated with orbital tissue displacement. Median orbital volume change was 0.804 (0.647-1.010) cm 3 . Average proptosis variation was 1.2±0.8mm. Poly (L-lactide-co-glycolide) plates were more suitable for orbital BOF with small defect size. Those with large defect or maxillo-ethmoidal strut involved might have greater tissue displacements due to decline of supporting strength of poly (L-lactide-co-glycolide) plates.

White-Eyed Orbital Blowout Fracture With Oculocardiac Reflex Secondary to Extraocular Entrapment in a Pediatric Patient

White-eyed orbital blowout fractures in the pediatric population can present with acute onset diplopia, ophthalmalgia, and abnormal duction. These findings are attributed to the tendency of younger bone to break and reapproximate owing to greater elasticity. This phenomenon, commonly referred to as the greenstick fracture, increases the risk of entrapment of surrounding soft tissue structures in orbital floor fractures. Further concern arises in the presence of an oculocardiac reflex, which requires urgent intervention to prevent serious bradycardia. Prolonged entrapment can go unnoticed and result in irreversible ischemic damage to entrapped tissues. This case discusses the presentation 16-year-old female who sustained a left sided, white-eyed blowout fracture from a face-first ground level fall. On admission, she displayed restrictive strabismus and mild periorbital edema around the left eye. Vertical gaze was restricted when looking inferiorly on the affected side. With sustained upward gaze, her heart rate decreased from 99 to 81 beats per minute. High-resolution non-contrast computed tomography scans of the head showed entrapment of the inferior rectus muscle and periorbital fat. Liberation of entrapped tissues with reduction of bony segments was performed urgently, utilizing a MEDPOR® Titan 3D orbital floor plate and secured with two screws. The patient had an uneventful postoperative period and showed considerable improvements in periorbital edema, duction, and ophthalmalgia on the affected side. In addition, the oculocardiac reflex could no longer be elicited on prolonged upward gaze. Mild and improving paresthesia was noted in the maxillary distribution of the left trigeminal nerve. Sensory deficits like this are the result of fracture communication with the infraorbital canal, which may cause irritation of the infraorbital nerve responsible for sensation by the maxillary division. By postoperative week 7, she had complete resolution of periorbital edema, indiscernible duction abnormalities, and complete healing of surgical incision sites, and an oculocardiac reflex could not be elicited.

“ Initial experience with augmented reality for treatment of an orbital floor fracture – A Technical Note ”

The marked developments in the fields of 3D planning and printing in the last few decades, have enabled the application of virtual surgical planning (VSP) toward personalization of surgical procedures and implants. Augmented reality superimposes digital content on the real-world reality. The aim of this technical note was to introduce the use of AR to evaluate and guide the insertion and positioning of a patient specific implant (PSI) for orbital floor blow-out fracture reconstruction. A 31-year-old, healthy male was injured and suffered from left orbital floor blow-out fracture. DICOM images of the CT scan were obtained for segmentation and for VSP, PSI design and 3D Printing. Patients’ file with the 3D objects was uploaded to AR software. The patient's left orbital floor was approached via the trans-conjunctival incision, PSI titanium plate was set in place and using AR Special head-mounted displays (HoloLens 1, Microsoft) the correct planned position of the plate was confirmed. The post-operative CT scan showed a <0.3 mm discrepancy in all axes of the plate in relation to the planned position. AR application in medicine and in maxillofacial surgery bears great potential, However, further investigation of this technology is required

Successful Management of Post-Traumatic Residual Orbital Roof Defects with Cosmetic Disfigurement and Functional Deficits Using Innovative Titanium Plate Orbitoplasty.

Late presentations of post-traumatic residual orbital roof deformities ensuing from old, unaddressed orbital injuries, can be extremely challenging to manage and quite complicated to correct, owing to proximity of the brain and frontal sinus, malunion or bony fusion of the displaced, delicate orbital fracture fragments, necrosis of entrapped extraocular muscles and progressive intraorbital soft tissue fibrosis and adhesions. There exists a paucity in literature on delayed repair of displaced and comminuted orbital roof fractures and late reconstruction of the three-dimensional architecture of the orbital frame and internal orbit. To present an unusual case of severe post-traumatic residual orbital roof deformity, resulting in longstanding aesthetic disfigurement and persisting functional deficits, and its successful management. The patient had sustained orbital injuries sixteen months ago, on being punched in the face at a boxing tournament. The increased orbital volume produced by an impure blowout fracture of the left orbital roof, with comminution of the upper and lower orbital rims, had resulted in considerable cosmetic deformity, discomfort as well as functional debility, all of which were successfully and efficaciously managed by an innovative use of a Titanium Orbital Plate for orbital roof reconstruction. Overlooked, undetected or ignored derangements in intraorbital volume and contour, can lead to severe cosmetic disfigurement in the form of enophthalmos, hypoglobus, entropion, telecanthus, palpebral fissure width narrowing and ptosis; in addition to crippling functional deficits, such as diplopia, blurred vision, levator dysfunction, restricted ocular motility and reduced visual range and acuity. An innovative Titanium mesh orbitoplasty enabled achievement of both, the aesthetic and functional goals of reconstruction of the distorted bony orbit, with successful correction of severe functional and aesthetic deficits.

Orbital Apex Syndrome and Central Retinal Vein Occlusion after Blow-out Fracture Repair

Purpose: To report a case of orbital apex syndrome and central retinal vein occlusion after blow-out fracture repair.Case summary: A 22-year-old man who underwent emergency re-operation in a department of plastic surgery due to pain, decreased visual acuity, and ophthalmoplegia in all direction after orbital blow-out fracture repair was referred to ophthalmologist on postoperative day 2 and there was no improvement in symptoms. He showed severe complications, including optic neuropathy and ophthalmoplegia in all direction, central retinal vein occlusion, and outer retinal disruption caused by orbital apex hemorrhage. Although we were concerned that it was too late, we started high dose steroid intravenous pulse treatment and the visual acuity, ophthalmoplegia, and retinal findings were improved. However, the optic atrophy and visual field defect did not.Conclusions: After a complicated blow-out fracture repair in other department, if a patient shows severely decreased visual acuity or ocular movement limitation, a thorough and immediate ophthalmologic examination is recommended. During ophthalmologic examination, meticulous examination of the entire eye, including the retina, is required, in addition to general orbital complications. A relatively good prognosis can be expected through accurate cause analysis and appropriate treatment for the confirmed abnormal findings.

Invited commentary on “Reflections on a patient-centered approach to treatment of blow-out fractures: Why the wisdom of the past must guide our decision making”

Blow-out fractures are probably the most controversial facial fractures in terms of surgical treatment indication, options, and protocols.1 The current paper by Paolo Scolozzi2 emphasizes that despite the great advances in terms of imaging-based technologies available, clinical observations are the most important assistive tool for decision making.

Analysis of Patients With Blowout Fracture Caused by Baseball Trauma

Abstract The purpose of this study was to investigate the characteristics of blowout fractures caused by baseball trauma. The authors reviewed 337 cases of blowout fracture surgeries and included 330 eyes of 330 patients who underwent blowout fracture reconstruction between January 2017 and December 2020, in the Department of Ophthalmology at Korea university Hospital. Medical records including patient demography, trauma etiology, accompanied ocular disease, and preoperative computed tomography images were evaluated. Patients were categorized into 2 groups: a group with blowout fracture caused by baseball trauma and another group with trauma due to other causes. Two-wall blowout fracture (orbital floor fracture and medial wall fracture) was most common (63.16%) in the baseball group, followed by medial wall fracture (21.05%). In contrast, orbital floor fracture accounted for the largest proportion (42.11%) among other causes, and 2-wall blowout fracture accounted for the second largest proportion (31.83%). The most common accompanied ocular disease was traumatic hyphema and traumatic iridocyclitis (36.84%) in the baseball blowout fracture group. in contrast, subconjunctival hemorrhage was the most common ocular disease in the other-causes group (16.08%). The frequency of traumatic hyphema and irido-cyclitis was significantly different among the 2 groups (P &lt; 0.05). Distribution of blowout fracture sites and frequent ocular disease differed between baseball blowout fracture patients and other-cause blowout fracture patients.

Radiographic volumetric risk factors for late enophthalmos prediction in orbital blow-out fractures: A retrospective study

The aim of this study was to assess the correlation between volumetric risk factors, orbital volume (OV), orbital volume ratio (OVR), herniated volume (HV), and the newly described herniated volume ratio (HVR), with the occurrence of late enophthalmos.Patients presenting a unilateral unoperated blow-out fracture were retrospectively included. OV and HV were measured using planimetry on the initial CT scan images. OVR and HVR were then calculated. Enophthalmos was measured on the 2-month follow-up CT scan images. The population was divided into two groups according to their enophthalmos status. Correlations and multiple linear regression model were used.17 patients out of 45 presented a late enophthalmos of 1 mm or more. There were significantly higher OVR (107 (3.76); p < 0.0001), HV (0.8 (0.47); p < 0.0001) and HVR (3.3 (1.82); p < 0.0001) in the enophthalmos group. A very strong linear correlation between enophthalmos and OVR (rs = 0.806), HV (rs = 0.948) and HVR (rs = 0.951) was found.Enophthalmos prediction using these volumetric parameters can help the surgeon's decision-making in orbital blow-out fractures in order to prevent late enophthalmos. Measurement is simple and reproducible. However, larger prospective studies are needed to confirm these results.

Is Surgery Needed for Diplopia after Blowout Fractures? A Clarified Algorithm to Assist Decision-making.

Background:Diplopia is a common symptom after blowout fractures, with an incidence of 43.6%–83%. Although there is some consensus toward surgical correction, diplopia is not always resolved by surgery. Thus, there is a clinical dilemma for surgeons with regard to performing surgery at a specific time. This review aimed to create an algorithm to support accurate and effective decision-making.Methods:We reviewed articles published on PubMed during 2013–2020 regarding orbital fractures. Articles discussing surgical treatment for blowout fractures and diplopia were included. Five reviews, six prospective cohort studies, and 33 retrospective studies were identified. After reviewing and summarizing these articles, a step-by-step algorithm was created.Results:Most authors advise immediate surgery when a patient presents with either a positive oculocardiac reflex or a “trapdoor” fracture. Early surgical correction is recommended in children to prevent profound muscle damage. In other scenarios, most authors recommend performing surgery within 2 weeks. The algorithm begins with the aspect of motility, including muscle entrapment assessed by computed tomography or limited movement of the extraocular muscle. When there is no abnormality in motility, the algorithm continues to the aspect of position. Generally, an orbital floor defect of more than 50% or 2 cm2 or an enophthalmos of more than 2 mm is indicated for surgery. However, diplopia may also gradually resolve after improvement of periorbital edema or swelling.Conclusion:We proposed a step-by-step approach to help surgeons make effective decisions concerning surgical correction for patients suffering from blowout fractures with diplopia at different time points.

Sports-related ocular injuries at a tertiary eye hospital in Australia: A 5-year retrospective descriptive study.

To describe the demographics and outcomes of sports-related ocular injuries in an Australian tertiary eye hospital setting. Retrospective descriptive study from the Royal Victorian Eye and Ear Hospital from 2015 to 2020. Patient demographics, diagnosis and injury causation were recorded from baseline and follow-up. Outcomes included visual acuity (VA), intraocular pressure (IOP), ocular injury diagnosis, investigations and management performed. A total of 1793 individuals (mean age 28.67 ± 15.65 years; 80.42% males and 19.58% females) presented with sports-related ocular trauma. The top three injury-causing sports were soccer (n= 327, 18.24%), Australian rules football (AFL) (n= 306, 17.07%) and basketball (n= 215, 11.99%). The top injury mechanisms were projectile (n= 976, 54.43%) and incidental body contact (n= 506, 28.22%). The most frequent diagnosis was traumatic hyphaema (n= 725). Best documented VA was ≥6/12 at baseline in 84.8% and at follow-up in 95.0% of cases. The greatest risk of globe rupture/penetration was associated with martial arts (odds ratio [OR] 16.22); orbital blow-out fracture with skiing (OR 14.42); and hyphaema with squash (OR 4.18): P< 0.05 for all. Topical steroids were the most common treatment (n= 693, 38.7%). Computed tomography orbits/facial bones were the most common investigation (n= 184, 10.3%). The mean IOP was 16.1 mmHg; 103 (5.7%) cases required topical anti-ocular hypertensives. Twenty-six individuals (1.45%) required surgery with AFL contributing the most surgical cases (n= 5, 19.23%). The top three ocular injury causing sports were soccer, AFL and basketball. The most frequent injury was traumatic hyphaema. Projectiles posed the greatest risk.

Accuracy of the Application of 3-Dimensional Printing Models in Orbital Blowout Fractures-A Preliminary Study.

Application of 3-dimensional (3D) printing technology has grown in the medical field over the past 2 decades. In managing orbital blowout fractures, 3D printed models can be used as intraoperative navigators and could shorten the operational time by facilitating prebending or shaping of the mesh preoperatively. However, a comparison of the accuracy of computed tomography (CT) images and printed 3D models is lacking. This is a single-center retrospective study. Patients with unilateral orbital blowout fracture and signed up for customized 3D printing model were included. Reference points for the 2D distance were defined (intersupraorbital notch distance, transverse horizontal, sagittal vertical, and anteroposterior axes for orbital cavity) and measured directly on 3D printing models and on corresponding CT images. The difference and correlation analysis were conducted. In total, 9 patients were reviewed from June 2017 to December 2020. The mean difference in the intersupraorbital notch measurement between the 2 modules was -0.14 mm (P = 0.67). The mean difference in the distance measured from the modules in the horizontal, vertical, and anteroposterior axes of the traumatic orbits was 0.06 mm (P = 0.85), -0.23 mm (P = 0.47), and 0.51 mm (P = 0.32), whereas that of the unaffected orbits was 0.16 mm (P = 0.44), 0.34 mm (P = 0.24), and 0.1 mm (P = 0.88), respectively. Although 2D parameter differences (<1 mm) between 3D printing models and CT images were discovered, they were not statistically significant. Three-dimensional printing models showed high identity and correlation to CT image. Therefore, personalized models might be a reliable tool of virtual surgery or as a guide in realistic surgical scenarios for orbital blowout fractures.

Surgical Repair of Orbital Blow-Out Fractures: Outcomes and Complications.

Objectives:The purpose of this study is to evaluate the demographics of patients with orbital blow-out fractures, as well as the success and complications of surgical repair with porous polyethylene membrane sheet implants through transconjunctival technique and to compare the results to previously published studies.Methods:This retrospective study included 57 patients diagnosed with orbital blow-out fractures referred to our clinic between 2018 and 2022. Seventeen patients (29.8%) underwent orbital fracture repair through a transconjunctival technique employing porous polyethylene membrane sheets. The indications for surgery were enophthalmos >2 mm and persistent ocular motility restriction, diplopia, and strabismus. The success criteria were <2 mm of enophthalmos and complete correction of eye motility, diplopia, and strabismus.Results:The study group consisted of ten females and 47 males with a mean age of 31.12 years. The most common cause of injury was assaults (50.9%), followed by falls (38.6%), traffic accidents (5.3%), and accidental impacts (5.3%). The inferior wall (61.4%) was the most common fracture site, followed by the medial wall (21.1%) and a combination of the inferior and medial walls (21.1%). The surgically treated group showed a significant improvement in ocular motility restriction (88.2–23.5%, p=0.002), diplopia (70.6–23.5%, p=0.008), and enophthalmos (1.41 mm to 0.82 mm, p=0.012) after surgery. The surgery was successful in ten of 17 cases (58.8%), and the success rate was higher in patients who were treated early (77.8% vs. 37.5%), but the difference was not statistically significant (p=0.092).Conclusion:Orbital blow-out fracture repair using porous polyethylene membrane sheets through a transconjunctival approach is a safe and effective surgical technique for orbital blow-out fracture repair. Although patients who had early surgery had a higher success rate in our study group, larger study groups are needed to assess the effect of surgical timing on success.