J Korean Ophthalmol Soc.  2014 May;55(5):640-645. 10.3341/jkos.2014.55.5.640.

Reconstruction of Orbital Medial Wall Fracture with Absorbable and Non-Absorbable Orbital Implant: Comparative Study

• Kim MK
• Jang SY
• Choi HS

• KMID: 2218083
• DOI: http://doi.org/10.3341/jkos.2014.55.5.640

Abstract

PURPOSE
To compare the surgical results and complications of medial wall fracture reconstruction using non-absorbable porous polyethylene implants (Medpor(R), Stryker Instruments, Kalamazoo, Michigan, USA) and an absorbable polymer of polyglycolic acid (PGA) and polylactic acid (PLA) (Mesh plate(R), Inion Ltd, Tampere, Finland).
METHODS
We retrospectively reviewed the data of patients who underwent reconstruction of medial wall fracture between January 2007 and June 2012 and divided them into 2 groups according to orbital implant type (Medpor(R), Mesh plate(R)).
RESULTS
Among the 86 patients, 37 were treated with Medpor(R) and 49 with Mesh plate(R). There was no statistically significant difference in limitation of motion or diplopia score between the 2 groups at postoperative 6 months (Fisher's exact test, p = 0.192, p = 0.128, respectively). Mean postoperative exophthalmometry differences between the eyes were 0.49 +/- 1.04 mm and 0.37 +/- 0.62 mm in Medpor(R) and Mesh plate(R) groups, respectively, showing no statistically significant difference (independent t-test, p = 0.512). Postoperative complications such as inflammation or implant malposition were observed only in 3 patients in the Medpor(R) group.
CONCLUSIONS
No difference was observed between Medpor(R) and Mesh plate(R) in terms of surgical results during the postoperative 6 month period after reconstruction of orbital medial wall fracture. However, postoperative complications were observed in 3 patients in the Medpor(R) group.

Keyword

Implants; Medial wall fracture; Medpor; Mesh plate; Orbital wall reconstruction

MeSH Terms

Diplopia
Humans
Inflammation
Michigan
Orbit*
Orbital Implants*
Polyethylene
Polyglycolic Acid
Polymers
Postoperative Complications
Retrospective Studies
Polyethylene
Polyglycolic Acid
Polymers

Figure

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  Figure 1. Pre and post-treatment external photographs (A, B, D) and CT scans (C, E) of the patient who developed inflammation around the plate after reconstruction of a medial wall fracture with Medpor®. A 65-year-old patient presented with erythematous swelling of the left upper and lower eyelids 2 years after open reduction of medial wall fracture with Medpor® (A, B). CT scan shows marked proptosis of left eye and increased dirty densities along the surgical plate (C). The patient received systemic steroid treatment and eyelid swelling improved (D). CT scan shows decreased densities along the surgical plate, suggesting improvement of inflammation (E).

• 

  Figure 2. CT scan of the patient who complained of epiphora and palpable plate, suggesting malposition of surgical plate after reconstruction of a medial wall fracture with Medpor®. A 55-year-old patient presented with epiphora of the right eye 1 month after open reduction of a medial wall fracture with Medpor®. CT scan showed lacrimal sac compression by surgical plate, and ocular symptoms were improved after surgical plate removal.

Reference

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