Orbital floor fracture defect size and inferior rectus (IR) rounding index are currently accepted indications for surgery to prevent late enophthalmos.

The authors analyzed the positive predictive value (PPV) of these indications.

Methods:

Twenty-eight patients with orbital floor fractures presenting without enophthalmos underwent Hertel exophthalmometry at presentation and at weeks 1, 2, 3, 6, 13, 26, and 52 or more after injury.

Orbital defect size and IR rounding index were measured from computed tomographic scans, and PPVs of defects of 1.5 to 2 cm2 or larger and IR rounding index of 1 or higher for enophthalmos (≥2 mm) were calculated.

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