Author reply

We thank Perry et al for their interest in our paper and for sharing their experience with the transcaruncular approach. We entirely agree that, in experienced hands, the approach can provide adequate exposure of the orbital apex in the majority of cases. Failure to visualize the apex may certainly also be owing to inadequate extension of the incision to the fornices to enable better exposure. Our retrospective study simply presents our experience with using the endoscope in medial wall fractures that extend to the apex. We do not propose that this is a superior technique, but have found that it has been a significant aid to visualization for us in these selected cases. We have had difficulty in our Asian population in obtaining good visualization, particularly in the presence of traumatized and edematous orbital soft tissues. The endoscope provides magnification and illumination, which we have found to be helpful in fracture exposure and accurate implant placement. Hence, it has been a useful addition to our armamentarium for these cases. We thank Perry et al for their comments and the opportunity to further clarify our experience.