Lower incidence of chemosis with the Berke incision approach versus the swinging eyelid approach after deep lateral orbital wall decompression

Abstract

Purpose: To compare the incidence of chemosis following deep lateral orbital wall decompression using the Berke incision approach vs the swinging eyelid approach. Methods: This study retrospectively reviewed 49 sides in 29 patients who underwent decompression via the Berke incision approach (Group A) and 122 sides in 71 patients who underwent decompression via the swinging eyelid approach (Group B). Results: The incidence of chemosis was significantly lower in Group A (30.6%) compared with Group B (48.4%; p = 0.034). Although the period until subsidence of chemosis did not differ between the groups (p = 0.164), the ratio of sides that needed intensive postoperative care was lower in Group A than in Group B (p = 0.002). Chemosis tended to occur more frequently in sides with a history of steroid administration relative to those without previous steroid administration (Group A, p = 0.042; Group B, p = 0.059), although past radiation therapy and past combined radiation and steroid therapy did not influence the occurrence of chemosis (p > 0.050). Postoperative proptosis reduction was similar in both groups (p = 0.087). Conclusion: It was found that the Berke incision approach yielded a lower incidence of chemosis while achieving similar postoperative proptosis reduction in comparison with the swinging eyelid approach. These findings suggest that the Berke incision approach is an acceptable alternative procedure for deep lateral orbital wall decompression.

Key Words:

• Chemosis
• Berke incision approach
• swinging eyelid approach
• deep lateral orbital wall decompression

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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