Subciliary versus swinging eyelid approach to the orbital floor

Giacomo De Riu, Silvio Mario Meloni, Roberta Gobbi, Damiano Soma, Alessandro Baj, Antonio Tullio

Research output: Contribution to journalArticlepeer-review


In this retrospective study, the authors compare the outcomes of two different approaches to the orbital floor: the classic subciliary versus the transconjunctival plus lateral canthotomy (swinging eyelid). Forty-five patients who underwent orbital surgery (47 approaches) for different indications (orbital fractures, correction of Grave's exophthalmos, tumours of the internal orbit and correction of enophthalmos in secondary trauma) were placed in two groups, depending on the approach. The long-term effects of the incisions, the outcome of the approach and the complications were recorded and compared. The minimum follow-up for inclusion in the study was 1 year. Twenty-three orbits underwent subciliary incision, and 24 underwent swinging eyelid. No ectropion or entropion was seen in any patient. For the swinging eyelid approach, complications included three cases (12.5%) of canthal malposition; for the subciliary approach, five cases (21.14%) of lagophthalmos and 10 visible scars were observed. Our findings show the advantages of the swinging eyelid: better aesthetic results, the same or greater exposure of the orbital floor and the caudal part of the lateral and medial walls, shorter surgical time (sutureless) and a less extended scar. Although in our experience this approach is preferable in orbital surgery, some indications for the subciliary still remain.

Original languageEnglish
Pages (from-to)439-442
Number of pages4
JournalJournal of Cranio-Maxillofacial Surgery
Issue number8
Publication statusPublished - Dec 2008


  • orbital approach
  • orbital surgery
  • swinging eyelid

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology
  • Surgery


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