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Background: The influence of orbital fractures and their repair on the rate of deformities of the lower eyelid is
an ongoing source of discussion in the literature. Most of the present studies include isolated blow-out as well as
combined orbital fractures.
Material and Methods: We present a retrospective evaluation of a series of 100 patients after isolated blow-out
fracture repair using reference anthropometric data on standardized photographs. Analysis included eye fissure
width and height, lid sulcus height, upper lid height, upper and lower iris coverage, position of cornea to palpebra
inferior, canthal tilt, scleral show, ectropion and entropion. It was clearly distinguished between operated and contralateral
eyelid, whether a transconjunctival or a subciliary approach was performed and amount of fracture. Our
main interests were changes of the aforementioned parameters with regards to eyelid deformities.
Results: Surgery per se did not significantly influence eyelid deformities. However, the surgical approach selected
significantly affected eye fissure index, lower iris coverage and rate of scleral show, indicating retraction of the
lower eyelid.
Conclusions: The standardized measurements described here are accurate and objective to evaluate postoperative
results. The subciliary approach included the highest risk of lower lid retraction as compared to transconjunctival
approaches.
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