Use of the preseptal transconjunctival approach in orbit reconstruction surgery

Purpose: This report evaluated the advantages of the preseptal transconjunc tival approach in reconstruction of the orbit. Patients and Methods: Ninety-nine preseptal incisions were used in 80 patie nts for different indications (blowout fracture, complex zygoma fracture, e nophthalmos correction, midface hypoplasia, secondary incision). All operat ive procedures were performed without an additional lateral canthotomy. The infraorbital rim was stabilized with miniplates or microplates. Results: There was no ectropion or entropion in any patients. Complications included 1 laceration of the tarsal plate and 1 temporary entropion after a primary subciliary incision. The overall complication rate was 2%. Conclusions: The preseptal transconjunctival incision without lateral canth otomy provides good exposure of the orbital floor and the caudal parts of t he lateral and medial wall. This approach is preferable to a retroseptal ap proach in reconstructive orbital surgery because of minimal disturbance of the intraorbital connective tissue framework. The anatomic optimal dissecti on line also results in a lower complication rate. (C) 2001 American Associ ation of Oral and Maxillofacial Surgeons.