Complications following surgery are common, particularly in procedures involving the orbit. Various surgical approaches such as subciliary, subtarsal, and infraorbital incisions often lead to scar formation, which is an inevitable outcome. In contrast, the transconjunctival incision, performed over the palpebral conjunctiva, avoids visible scarring and offers distinct advantages. This case series aims to present the outcomes of using the transconjunctival access in patients with orbital trauma, including infraorbital rim and floor fractures, revision surgery for residual post-traumatic orbital deformities, and ocular cleft revisions.

This retrospective study included 15 patients who underwent surgical intervention via transconjunctival access. The patients presented with orbital trauma affecting the infraorbital rim and floor, post-traumatic deformities, and those requiring corrective surgery for Tessier 4 cleft. Surgical procedures were performed with careful attention to minimizing visible scarring and optimizing functional and aesthetic outcomes.

The transconjunctival approach was successfully used in all cases, with no visible external scars. All patients showed significant improvement in both functional and aesthetic outcomes. In cases of orbital trauma, the restoration of anatomical structure was achieved, while patients undergoing Tessier 4 cleft revision showed substantial correction of the deformity. Complications were minimal, with no major postoperative issues.

The transconjunctival surgical approach for orbital trauma, post-traumatic deformities, and Tessier 4 cleft revisions provides a highly effective, scar-free alternative to traditional incisions. This method not only enhances aesthetic outcomes but also ensures functional restoration, making it a viable option for managing complex orbital and facial injuries.