Current Guidelines and Opinions in the Management of Orbital Floor Fractures

Orbital floor fractures remain a common complication of facial trauma. Ophthalmic ex-amination and evaluation of the globe are an essential first step in the management of orbital fractures. Indications for repair include entrapment of orbital tissue, large frac-ture defects with herniation of orbital contents, persistent diplopia, and clinically sig-nificant enophthalmos. The transconjunctival approach for surgical repair is preferred to reduce the risk of cicatricial lid malposition. There is currently no compelling evi-dence supporting inpatient management following fracture repair or the use of intra-operative CT in isolated primary orbital floor fractures. Postoperative CT should be reserved for cases with specific postoperative clinical indications. Alloplastic implant materials are widely preferred, and implant choice remains controversial and variable between surgeons based on training and expertise.