J Korean Ophthalmol Soc.  2009 Dec;50(12):1761-1767. 10.3341/jkos.2009.50.12.1761.

Results of Reconstruction of Orbital Wall Fracture With Bioresorbable Plate

• Lim HS
• Kook KH

• KMID: 2212985
• DOI: http://doi.org/10.3341/jkos.2009.50.12.1761

Abstract

PURPOSE
To investigate the long-term results and complications of orbital wall fracture reconstruction using the bioabsorbable orbital implant, Macropore(R) orbital floor liner.
METHODS
This retrospective study included patients who underwent the reconstruction of an orbital wall fracture using Macropore(R) orbital floor liner and completed a postoperative follow-up longer than 6 months. The enophthalmic values as well as the data of ocular movement and diplopia was collected from the medical records of each patient and analyzed.
RESULTS
A total of 35 patients were evaluated with an average follow-up period of 14.0 months. The average enophthalmic value of 29 patients, whose reconstruction was primarily indicated from enophthalmic tissue, was 0.90 mm at the last follow-up. No significant progression of enophthalmos was observed at postoperative 12, 18 and 24 months when compared with the enophthalmic value at postoperative 6 months. All 15 patients who have had the limitation of ocular movement or diplopia preoperatively resolved completely or improved to the degree that no clinically significant limitation or diplopia further existed. No complications such as dislocation of implant, infection, and aggravation of ocular limitation were observed during the follow-up period.
CONCLUSIONS
Macropore(R) orbital floor liner may be regarded as a useful implant in reconstruction of orbital wall fracture with no significant implant-related complications during its absorption.

Keyword

Bioabsorbable plate; Enophthalmos; Macropore; Orbital wall fracture

MeSH Terms

Absorption
Diplopia
Dislocations
Enophthalmos
Floors and Floorcoverings
Follow-Up Studies
Humans
Medical Records
Orbit
Orbital Implants
Retrospective Studies

Figure

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  Figure 1. Classification of orbital wall fracture according to the percent of bony defect in coronal CT scan in which the maximum defect is observed. (A) Small size fracture: less than 25% of bony defect, (B) Medium size fracture: between 25 and 75% of defect. (C) Large size fracture: more than 75% of defect.

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  Figure 2. The enophthalmic values of patients during follow-up periods.

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  Figure 3. Preoperative (A) and immediate postoperative (B) CT of the patient who showed 3 mm of enophthalmos at postoperative 6 months. (A) Large-size right inferior orbital wall fracture is noted preoperatively. (B) Well reconstructed inferior orbital wall with Macropore® orbital floor liner is observed (arrow).

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  Figure 4. Computerized tomography (CT) of patient who were followed up to postoperative 24 months. (A) Large size right inferior orbital wall fracture is noted preoperatively. (B) In immediate postoperative CT scan, orbital floor is well reconstructed with Macropore, which is seen as a radiolucent line. (C) The contour of orbital floor including inferior rectus muscle is well maintained at postoperative 24 months. The area where Macropore was located previously is replaced by soft tissue (probably thought as fibrotic tissue) (short arrow), and the line with bone density outlines the orbital floor, which suggests calcification (long arrow).

Reference

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