Comparison of Trans Conjunctival Approach versus Infraorbital Approach for Infraorbital Rim and Orbital Floor Fractures-A Prospective Clinical Study

The contemporary surgeon faces the challenge of dealing with orbital trauma, reconstruction and aesthetics. Transconjunctival, subciliary, subtarsal and infraorbital incisions are used to approach the infraorbital rim/floor. Infraorbital incision produces a noticeable cosmetically disfiguring scar. Transconjunctival incision, on the other hand, leaves an inconspicuous scar which heals rapidly and uneventfully, but demands surgical precision. The purpose of this study was to compare the infraorbital and the transconjunctival approach for treatment of infraorbital rim and/or orbital floor fractures with regard to accessibility and exposure of the fracture site, aesthetics and postoperative complications. 18 patients, diagnosed with orbital floor fractures and/or infraorbital rim fractures, with or without other facial skeleton fractures respectively were divided into two groups based on their preference for either the infraorbital or the transconjunctival incision. The control group comprised of 11 infraorbital incisions and the study group of 11 transconjunctival incisions. We found that the transconjunctival incision provides adequate exposure to the surgical field, allows rapid healing leaving an unnoticeable scar, and causes minimal postoperative complications as compared to the infraorbital incision.