J Korean Ophthalmol Soc.  1987 Apr;28(2):463-469.

The Direct Medial Canthal Approach in the Repair of Blowout Fracture of the Medial Orbital Wall

  • 1Department of Ophtealmology, Capital Armed Forces General Hospital, Seoul, Korea.
  • 2Department of Ophthalmology, Korea University, College of Medicine, Seoul, Korea.


Fracture of the medial orbital wall with entrapment of the medial rectus muscle is a rarely reported occurence. Fractures of the medial orbital wall can occur alone. but they are frequently associated with fractures of the orbital floor. As the result of blowout fracture of the medial orbital wall, epistaxis, limitation of abduction, restriction of abduction, globe retraction upon attempted abduction, and enophthalmos are developed. Serious complications of medial orbital wall trauma are rare. Significant enophthalmos, definite limitation to the forced ductions, or marked incarceration of orbital tissue are usually indications for the need for exploration. Surgical approaches to blowout fracture of the medial orbital wall are made through a skin incision in the lower eyelid placed just below the eyelashes, a conjunctival incision, and direct medial canthal incision. Recently, the authors have repaired two blowout fractures of the medial orbital wall by use of Direct Medial Canthal approach, and follow-up for six months has been done.

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