Orbital Blow-Out Fracture Surgery and Enophthalmos (Sunken Eyes)

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Eye and eye socket injuries occur fairly commonly. Injuries include eyelid laceration, canalicular laceration (tear drain injuries), orbital hemorrhage (bleeding), and orbital fractures (eye socket bone fractures, “blow-out fracture” with enophthalmos or true sunken eye). They can result from blunt eye trauma or sharp injuries, including many sport-related activities, falls, assaults, etc. The eyeball itself is also prone to injury and it too needs to be thoroughly examined and treated by an oculoplastic surgeon to protect it.

Orbital Blow-Out Fracture Surgery

An “orbital blow out fracture” results from trauma to the orbit and eye area with resultant force causing fracture of the orbit into the adjacent sinuses as the orbital bones are fragile and thin. The most common location of the fracture is the orbital floor followed by the medial wall. Not all orbital (blow out) fractures need to be surgically fixed. Criteria for orbital “blow out” fracture surgery include large fractures, diplopia (double vision), and enophthalmos (sunken eyes).

Orbital “blow out” fracture repair should be performed within the first 2 weeks of the trauma. Waiting longer can result in scarring and increased difficulty in the repair with lowered success rate. However, at times the surgeon is forced to address the problem later on for various reasons. For instance, sunken eyes from the orbital fracture can manifest or worsen later on. In those cases, surgery is performed later to improve sunken eyes (enophthalmos surgery).

Dr. Taban uses the latest minimally invasive technique to repair orbital fractures and has even penned an article about Orbital Wall Fracture Repair Using Seprafilm.

Read Article Published by Los Angeles' Dr. Taban about Orbital Wall Fracture Repair Using Seprafilm

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During your consultation with Dr. Taban in Beverly Hills/Los Angeles or Santa Barbara, he will evaluate your eyes and face and review orbital CT scan to assess the severity of the orbital fracture and need for orbital fracture surgery repair. Dr. Taban performs orbital fracture surgery using hidden incision inside the eyelids, with quick recovery. Orbital blow out fracture surgery is performed under general anesthesia, which usually takes about an hour to complete. As an outpatient procedure, the patient goes home after surgery and follows up in clinic a week later.

Enophthalmos surgery is done similarly to orbital fracture surgery, requiring an orbital implant. Sometimes, enophthalmos or sunken eyes can be helped with filler injection in the orbit or eyelid, in the office.

Orbital Implant to Treat Sunken Eye from Silent Sinus Syndrome

 

Left photo shows right orbital blow out fracture with inability to move the eye up. Right photo is 6 weeks after orbital fracture surgery with eye movement restored.
Left photo shows right orbital blow out fracture with inability to move the eye up. Right photo is 6 weeks after orbital fracture surgery with eye movement restored.

Before (left photo) and 3 months after (right photo) of a 40 year old female who underwent right eye sunken eye (enophthalmos) surgery. Note that the right eyeball is lower (termed hypoglobus) in the before photo and then in normal symmetric position in the after photo. She would also benefit from filler injection on both sides.Before (left photo) and 3 months after (right photo) of a 40 year old female who underwent right eye sunken eye (enophthalmos) surgery. Note that the right eyeball is lower (termed hypoglobus) in the before photo and then in normal symmetric position in the after photo. She would also benefit from filler injection on both sides.


Before (left) 40 year old male, with history of multiple large orbital fractures, with significant enophthalmos (sunken eye) and cheek fracture with sunken cheek. After (right) 4 months after right orbital fracture surgery, enophthalmos (sunken eye) surgery with orbital floor implant, and cheek implant.
Before (left) 40 year old male, with history of multiple large orbital fractures, with significant enophthalmos (sunken eye) and cheek fracture with sunken cheek. After (right) 4 months after right orbital fracture surgery, enophthalmos (sunken eye) surgery with orbital floor implant, and cheek implant.


Before (left) and after (right) sunken eye surgery (enophthalmos surgery) with right orbital implant placement.
Before (left) and after (right) sunken eye surgery (enophthalmos surgery) with right orbital implant placement.

Beverly Hills Orbital Fracture Repair
Before (left) young female teenager who suffered full-thickness left upper and lower eyelid laceration plus canalicular laceration (tear duct laceration) from surf board accident. 3 months after (right) eyelid, eyebrow and canalicular laceration repair. Note natural appearing results with minimal scarring.

Beverly Hills Eye Socket Laceration Repair
Before (left) middle age man with right orbital blow out fracture from a punch with inability to move the right eye up with double vision (diplopia). Nine months after (right) he underwent right orbital fracture repair with implant and restoration of eye movement.

Santa Barbara Eye Injury Specialist
Before (left) middle age woman with multiple right eyelid lacerations. Three months after (right) she underwent reconstructive eyelid laceration repair.

Who Should Treat Orbital and Eyelid Trauma?

The orbit is a small, compact and complex structure. The eyelid is also a mobile, complicated structure, made up of many different layers. Oculoplastic surgeons have undertaken the extra training to deal with the nuances of treating orbital and eyelid diseases and injuries. An oculoplastic surgeon, who is a member of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), is someone who is a board-certified ophthalmologist who has completed additional 2-year fellowship training in cosmetic and reconstructive plastic surgery of the eyelids, orbits (eye socket), lacrimal system( tearing system) and surrounding structures. Dr. Taban is double board-certified by American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), American Academy of Ophthalmology (AAO), and a diplomat of the American Board of Cosmetic Surgery (ABCS).

Contact TabanMD for a Consultation Today

Dr. Mehryar (Ray) Taban is a board certified ocular-plastic surgeon in Beverly Hills, Los Angeles and Santa Barbara with extensive knowledge in the treatment of orbital fractures and eyelid Trauma. To learn more about the different treatment options that may be suitable for you, contact Dr. Taban today to schedule an initial consultation.

I don’t know where to begin, but I want to get straight to the point. Dr. Taban is a phenomenal surgeon and I couldn’t be more happy I chose him to repair my orbital fractures. …

Kevin E.

Kevin E. November 2, 2016

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