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Purpose: To evaluate the effect of epinephrine on pupil size in reconstruction of an orbital wall fracture. Methods: The authors of the present study describe 27 patients (27 eyes) who had reconstruction of an orbital wall fracture from January to July of 2009. Patients were divided into two groups according to the use of epinephrine during surgery. Preoperative and postoperative pupil sizes, operation times, and epinephrine dosages were collected. Results: Preoperative pupil sizes were 1.80 ± 0.37 mm, 1.74 ± 0.36 mm and postoperative pupil sizes were 1.97 ± 0.43 mm (p = 0.042), 2.18 ± 0.52 mm (p = 0.003) in the group with of epinephrine and the group without epinephrine, respectively. Postoperative pupil size significantly increased in all groups. However, no significant difference was found regarding change in pupil size after surgery (p = 0.258). In the group with epinephrine, change in pupil size did not show a significant association with operation time (p = 0.228), nor did change in pupil size and epinephrine dosage (p = 0.922). Conclusions: The use of epinephrine is an effective modality for bleeding control and securing a clear view in orbital wall fracture reconstruction. J Korean Ophthalmol Soc 2011;52(6):653-657

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