Surgical Effect of Medpor in the Reconstruction of Orbital Wall Fracture

Kim, Hee Kyu; Lim, Heung Sik; Chung, Wha Sun

Abstract

The records of the patients with the orbital wall fracture were reviewed from January 1985 through December 1994 in the Department of Ophthalmology, Yeungnam University Medical Center. Eighteen patients were repaired orbital wall fracture using Medpor and 44 patients were repaired orbital wall fracture using silicone plate. Surgical effect of Medpor was evaluated and compared with that of silicone plate in the reconstruction of orbital wall fracture. Postoperative improvement of diplopia, extraocular muscle movement, enophthalmos and complications were evaluated after the follow-up period of 6 months. The incidence of the orbital fracture was more common in men than in women(p<0.05). The traffic accident was the most common cause of the wall fracture and the most common combined lesion was the lid laceration. The most common fracture site were the inferior wall, and combined medial and inferior walls. There were no significant difference between the two materials in improvement of limitation of the extraocular movement and diplopia(p>0.05). the improvement of enophthalmos were 1.2mm in case of Medpor and 1.1mm in silicone plate, but the difference between the two materials was insignificant(p>0.05). Six cases (33%) of the Medpor group and the nine cases (20%) of the silicone plate group caused the infraorbital hypoesthesia, but there was no significant diference between the two groups(p>0.05). Prolapse of the implant was noted in one case of silicone plate implantation, but it was not found in any case of Medpor implantation yet. Postoperative complications such as retrobulbar hematoma, optic nerve injury and lower eyelid retraction were not noted in the two procedures. In this study, Medpor revealed similar surgical effect as silicone palte in reconstruction of orbital wall fracture. However, Medpor has a remarkable characteristic of fibrovascular ingrowth keeping from prolapse or dislocation. Therefore it could be the most ideal implant for the repair of the orbital wall fracture at present.