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New research · Ophthalmology
The Journal of craniofacial surgery · 1d
Case-controlThe Journal of craniofacial surgery · 2026

A Systematic Review Comparing Endoscopic and Open Approaches in Orbital Fracture Surgery.

Gustavo Magalhães Albuquerque, Hana Shah, Sara E Munkwitz … Paulo G Coelho
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OphthalmologyCase-control

Endoscopic orbital fracture repair linked to lower odds of postoperative double vision

A Systematic Review Comparing Endoscopic and Open Approaches in Orbital Fracture Surgery.

Gustavo Magalhães Albuquerque … Paulo G Coelho
The Journal of craniofacial surgery · 2026
Background

Orbital floor fractures are a common form of facial bone injury and typically present with diplopia, infraorbital nerve paresthesia, and enophthalmos.

Purpose

This systematic review evaluated postoperative results (enophthalmos and diplopia) of open versus endoscopic orbital floor fracture repair.

Methods

This review included clinical trials and observational studies (cohort and case-control) in adults with surgically indicated orbital floor fractures comparing open external repair versus endoscopic repair.

n = 538 patients
Results

endoscopic repair patients were far less likely to see double after surgery

OR 0.32 (95% CI 0.13 to 0.79)
null 1
0.13
0.79
CI excludes the null - significant
More results

The search identified 266 records.

Seven studies met inclusion criteria, encompassing 538 patients (open: n = 340; endoscopic: n = 198).

Postoperative enophthalmos, evaluated in 6 studies, was also less frequent after endoscopic repair (odds ratio = 0.32; 95% CI: 0.13-0.79; p = 0.01).

More results

Endoscopic orbital floor fracture repair demonstrated lower postoperative incidence of diplopia and enophthalmos compared with open approaches, with statistically significant pooled effects and low to moderate heterogeneity.

“
Conclusion

Clinicians may consider endoscopic techniques in appropriate candidates, recognizing that evidence for secondary outcomes was limited by sparse and heterogeneous reporting.

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