Medial blowout fracture correction surgery for orbital volume increase plus ptosis correction by reattachment of levator palpabrae superioris

Road traffic accident leaves patient with a sunken left eye

This young woman is from Tirupur, Tamil Nadu. A road traffic accident resulted in injury around the left eye. This had resulted in a blowout fracture of the left eye. Surgery elsewhere resulted in a sunken left eye and residual ptosis. This was the result of fat herniation into a medial orbital wall fracture. A local oral surgeon referred her to our hospital for surgical correction.

Treatment planning explained to patient and consent obtained

Dr SM Balaji, facial deformity correction specialist, examined the patient. He explained that the sunken eye was due to herniated fat. The patient also needed ptosis correction. He explained that levator palpabrae superioris muscle needed corrective surgery. The patient consented to surgery.

Osteomesh utilized for correction of fat herniation into medial wall fracture

After general anesthesia, the medial wall of orbit fracture was first accessed. Herniated fat was then released from the fracture site. An Osteopor-Osteomesh was then inserted to cover the fracture site. This would form a permanent film over the fracture site. Fat herniation would thus not recur at the fracture site. Fine ophthalmic sutures were then used to close the incision.

Ptosis surgery done with full correction of deformity

The levator palpabrae superioris was next addressed. An incision was first made at the old scar site. The muscle was then accessed and a suture used to attach it to the orbicularis oculi. This incision was also closed with fine sutures.

The patient’s eye function was then tested after recovery from general anesthesia. The patient had symmetrical eyes with correction of the left eye ptosis. The patient expressed her satisfaction before discharge from the hospital.