Functional Outcomes Compared between Conservative Treatment and Surgical Treatment of Orbital Wall Fractures: a Retrospective Study

Purpose:The indications for orbital wall fracture vary with surgeons. For large orbital wall defects, most surgeons reach a consensus on early intervention. For small to moderate defects, however, there is debate. Radiological evaluation could assess the patient s orbital wall fracture location and its size to inform the surgeon s decision. The purpose of our study was to assess the radiological features of orbital wall fracture and its clinical symptoms and signs. Based on these data, we evaluate the criteria for moderate orbital wall fracture, which is treated conservatively. Methods: From January 2011 to December 2012, 213 patients diagnosed with orbital wall fracture were enrolled in the study. The clinical features and orbital computed tomographic images of each patient were retrospectively evaluated. Based on the size of the fracture area, which was calculated using orbital computed tomography, the differences in the clinical and radiological features of the conservative and surgical treatment group were evaluated. Results: The mean fracture area was significantly greater in the surgical group and there was a correlation between enophthalmos and the size of the fracture. After surgical treatment, the enophthalmos was corrected significantly. Conclusions: Orbital wall fracture with a fracture area smaller than 2.3 mm2 on computed tomography, enophthalmos under 2 mm and having no signs of extraocular muscle entrapment could be treated conservatively.