Abstract：
OBJECTIVE: Lower eyelid malposition can be a complication following orbital floor fracture surgeries. We present our incidence of lower eyelid malposition from a large case series of orbital floor fracture repairs using the \'swinging eyelid\' approach and \'hang back\' technique.
METHODS: A retrospective review of all orbital fracture surgeries at our institution from November 2011 to March 2021 was performed. Primary outcomes included the incidence of lower eyelid malposition by category, the average time to presentation after primary surgery, and reoperation rates among cases with lower eyelid complications.
RESULTS: A total of 438 cases that involved repair of the fractured orbital floor were identified. Six patients (1.37 %) developed lower eyelid malposition following primary orbital floor repair. Two patients (0.46 %) developed reverse ptosis of the lower eyelid. Two patients (0.46 %) returned with lower lid cicatricial ectropion. One patient (0.23 %) had postoperative lower eyelid retraction. One patient (0.23 %) had postoperative lower eyelid cicatricial entropion. No cases of lower lid flattening, lower eyelid fat flattening, or eyelid notch was noted. All patients with lower eyelid malposition underwent additional surgeries except one patient with reverse ptosis (83.3 %). The average time to the presentation of postoperative complications from the surgery date was 292.8 days (range = 49 days to 3.5 years).
CONCLUSIONS: Lower eyelid malposition after orbital floor repair is a known complication that can be decreased by employing the \'swinging eyelid\' with a preseptal approach and closure by the \'hang back\' technique.
METHODS: A retrospective review of all orbital fracture surgeries at our institution from November 2011 to March 2021 was performed. Primary outcomes included the incidence of lower eyelid malposition by category, the average time to presentation after primary surgery, and reoperation rates among cases with lower eyelid complications.
RESULTS: A total of 438 cases that involved repair of the fractured orbital floor were identified. Six patients (1.37 %) developed lower eyelid malposition following primary orbital floor repair. Two patients (0.46 %) developed reverse ptosis of the lower eyelid. Two patients (0.46 %) returned with lower lid cicatricial ectropion. One patient (0.23 %) had postoperative lower eyelid retraction. One patient (0.23 %) had postoperative lower eyelid cicatricial entropion. No cases of lower lid flattening, lower eyelid fat flattening, or eyelid notch was noted. All patients with lower eyelid malposition underwent additional surgeries except one patient with reverse ptosis (83.3 %). The average time to the presentation of postoperative complications from the surgery date was 292.8 days (range = 49 days to 3.5 years).
CONCLUSIONS: Lower eyelid malposition after orbital floor repair is a known complication that can be decreased by employing the \'swinging eyelid\' with a preseptal approach and closure by the \'hang back\' technique.
摘要：
目的：下眼睑错位可能是眶底骨折手术后的并发症。我们介绍了使用“摆动眼睑”方法和“挂回”技术进行的大型系列眶底骨折修复中下眼睑错位的发生率。
方法：回顾性回顾了2011年11月至2021年3月在我院进行的所有眼眶骨折手术。主要结果包括按类别划分的下眼睑错位的发生率，初次手术后的平均时间，下睑并发症的再手术率。
结果：共确认438例涉及眶底骨折修复的病例。6例患者（1.37％）在初次眶底修复后出现下眼睑错位。两名患者（0.46％）出现了下眼睑的反向下垂。两名患者（0.46％）返回下眼睑瘢痕性外翻。1例患者（0.23%）术后出现下眼睑退缩。1例(0.23%)患者术后出现下睑瘢痕性内翻。没有下盖压扁的情况，下眼睑脂肪变平，或注意到眼睑凹口。除1例反向上睑下垂患者（83.3％）外，所有下眼睑错位患者均接受了其他手术。从手术之日起出现术后并发症的平均时间为292.8天（范围为49天至3.5年）。
结论：眶底修复后下眼睑错位是一种已知的并发症，可以通过采用“摆动眼睑”和“悬垂”技术进行闭合来减少。
方法：回顾性回顾了2011年11月至2021年3月在我院进行的所有眼眶骨折手术。主要结果包括按类别划分的下眼睑错位的发生率，初次手术后的平均时间，下睑并发症的再手术率。
结果：共确认438例涉及眶底骨折修复的病例。6例患者（1.37％）在初次眶底修复后出现下眼睑错位。两名患者（0.46％）出现了下眼睑的反向下垂。两名患者（0.46％）返回下眼睑瘢痕性外翻。1例患者（0.23%）术后出现下眼睑退缩。1例(0.23%)患者术后出现下睑瘢痕性内翻。没有下盖压扁的情况，下眼睑脂肪变平，或注意到眼睑凹口。除1例反向上睑下垂患者（83.3％）外，所有下眼睑错位患者均接受了其他手术。从手术之日起出现术后并发症的平均时间为292.8天（范围为49天至3.5年）。
结论：眶底修复后下眼睑错位是一种已知的并发症，可以通过采用“摆动眼睑”和“悬垂”技术进行闭合来减少。
