Subciliary Versus Subtarsal Approach for The Management Of Infraorbital Rim And Orbital Floor Fractures. An Anthropometric Analysis

Purpose: the aim of this study was to assess the anthropometric changes of the morphology of the lower eyelid after the use of the subciliary (SCA) and subtarsal (STA) approaches in patients with infraorbital rim and orbital floor fractures.
Patients and methods: Twenty-six patients with orbital floor and infraorbital rim fractures were included in the study. They were divided equally into two groups. In group 1, the fractures of the orbital floor and infraorbital rim were approached via the stepped SCA, whereas in group 2, they were approached via the STA. All the cases were evaluated for the anthropometric changes in the morphology of the lower eyelid and the esthetic outcomes of the scars as well as the postoperative lower eyelid complications (LLCs). A paired sample t-test was used to analyze the difference between the operated and non-operated sides.
Results: The two approaches provided adequate exposure of the infraorbital rim and orbital floor. STA provided rapid access to the field. The anthropometric analysis revealed that there was no significant difference between the two approaches, except for the Eye fissure index (EFI) and lower iris coverage (LIC) measurements. The SCA had a significant increase in the EFI than the STA. Furthermore, the SCA showed a significant decrease in the measurements of the LIC.
Conclusion: The STA is a minimally invasive incision that provides adequate and direct exposure to the orbital floor and infraorbital rim fractures with more stable periorbital architecture and anthropometric measurements with the minimal incidence of postoperative complications.