Asymmetrical eyes following an orbital floor augmentation?

Question

My eyes are level, but orbital fat atrophy has caused one to become enophthalmic. A surgeon has recommended placing a sheet like implant outside the muscle cone on my orbital floor to improve projection. I know you can't give me a personal answer here, but generally, would you expect such a procedure to result in vertical asymmetry?

Jed H. Horowitz, MD, FACS · Answer

Correction #orbitalverticaldystopiayes is the brief answer but if the plate is place appropriately , it can move the eyeball forward.A craniofacial surgeon or experienced oculoplastic surgeon would be a good start

Mehryar (Ray) Taban, MD, FACS · Answer

It is possible that the orbital implant can lift the eyeball and cause asymmetry but it really depends on how the orbit is to begin with and what implant thickness is placed, among other factors such as eyelid position, etc. See an oculoplastic surgeon.

Kenneth D. Steinsapir, MD · Answer

Essentially they are unpredictable.  A number of complications can result from these procedures including loss of vision.  New asymmetries are common.  I strongly encourage you to get other opinions regarding this before proceeding.

Matthew Hansen, MBBS, FRACS (retired) · Answer

Thankyou for your question. Correction of longstanding enophthalmos is a challenging and somewhat risky operation and should only be performed by an expert craniofacial or oculoplastic surgeon who has a lot of experience. If your eyes are currently level with each other and the orbital walls and floor are equal in shape and position it is generally safer to augment the lateral wall of the orbit as this sits behind the eye and will more effectively push the orbital contents forward. Placing an implant below the eye does have a tendency to lift the eye rather than projecting it however if there has been an injury to the orbital floor (such as the relatively common "blowout fracture") then placement of a bone graft or implant in the orbital floor may be appropriate. Having said all that there is a real risk of damaging the eye with late correction of enophthalmos and you need to accept this risk and discuss this with your surgeon in detail before proceeding

Asymmetrical eyes following an orbital floor augmentation?

Answers (4)

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