AIM:To report the surgical outcomes of patients undergoing orbital fracture repair without periosteal closure·METHODS:All patients data were reviewed in a retrospective manner.Seventy-two patients(73 eyes) who underwent transconjunctival repair of isolated orbital fractures(n=51) or complex orbital fractures(n=21) without periosteal closure were included.A transconjunctival incision below the tarsus provided preseptal access to the inferior orbital rim,and transcaruncular incision provided access to the internal orbital fracture,after which the periosteum was incised for exploration and repair of orbital fracture.Forced ductions were performed after release of entrapped tissue and placement of orbital implants,and the periosteum was sutureless,conjunctiva was reapproximated with forceps and interruptedly sutured.Incidence of postoperative complications,including orbital implant exposure,infection,and migration was measured·RESULTS:All patients were followed up for 4-18(average 11) months postoperatively.One patient experienced lower lid retraction with entropion.Other complications included lateral canthal dystopia(n=3) or pyogenic granuloma at the lateral canthotomy site(n=1).There were no cases of postoperative implant exposure,infection,or migration·CONCLUSION:Forgoing closure of the periorbita after transconjunctival orbital fracture repair is associated with a low incidence of postoperative complications.This technique is applicable in the repair of both isolated orbital fracture and complex orbital fracture.