What Can Be Done To Widen The Interpupillary Distance In An Adult?

Q: Dr. Eppley, do you perform subcranial modified orbital box osteotomies?

A: You are referring to a lower 180 degree orbital box osteotomy done through a combined lower eyelid and intraoral incisional approaches, an operation of which I am familiar and have done. It is certainly far less invasive than the transcranial 360 degree orbital box osteotomies which allows it to fall into an aesthetic operation for properly selected adults. It is, however, more limited in what it can accomplish and thus its primary indication is when 10mm or less of orbital widening (interpupillary distance increase) is aesthetically needed. There are two variations of this type of limited orbital box osteotomy depending upon whether some cheek widening effect would also be desired.