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Updated: May 2, 2026
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Nylon foil (supramid) orbital implants in pediatric orbital fracture repair
Peter J Timoney1, Mark Krakauer, Byron N Wilkes
1*Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, University of Kentucky; †Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, University of Louisville; ‡Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, University of Tennessee; and §Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, Indiana University.
Insights
Nylon foil (Supramid) implants effectively repair pediatric orbital fractures with a low complication rate. This method demonstrates safety and efficacy in young patients needing orbital wall reconstruction.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Pediatric Surgery
Background:
- Orbital wall fractures are common in children, often resulting from trauma.
- Repair is crucial to restore function and aesthetics, but requires careful material selection.
Purpose of the Study:
- To evaluate the safety and effectiveness of nylon foil (Supramid) implants for pediatric orbital wall fracture repair.
- To assess surgical complications and patient outcomes.
Main Methods:
- Retrospective chart review of pediatric patients (≤18 years) treated with 0.4-mm Supramid implants between 2007-2010.
- Analysis of outcomes including diplopia and surgical complications.
Main Results:
- 57 patients (59 orbits) were included; average age was 12 years.
- Diplopia was the most common presenting symptom (33.3%). Combined orbital floor and medial wall fractures were most frequent (36.8%).
- Low complication rate (2 postoperative complications without permanent sequelae); diplopia resolved in all affected patients.
Conclusions:
- Nylon foil (Supramid) implants are a safe and effective option for pediatric orbital wall fracture repair.
- The low complication rate supports its use in this patient population.
Purpose:
To present the authors experience with the nylon foil (Supramid) implant as a safe and effective method to repair pediatric orbital wall fractures.
Methods:
A retrospective chart review of all pediatric patients (≤18 years) that underwent orbital wall fracture repair with an unsecured 0.4-mm Supramid implant between 2007 and 2010. Outcome variables were diplopia and surgical complications. This study was carried out with IRB approval.
Results:
A total of 59 orbits in 57 patients underwent orbital fracture repair using solely the 0.4-mm Supramid implant that were included in this retrospective chart review with the average age being 12 years. Trauma related to daily activities (42.1%) was the most frequent cause of orbital fractures. Eight patients (14.0%) had associated ocular/orbital injuries. Thirty-one patients (54.8%) were symptomatic at presentation with the most common presenting symptom being diplopia (n = 19, 33.3%). The most common fracture pattern sustained was combined orbital floor and medial wall fractures, which occurred in 21 patients (36.8%). Of the 3 patients (5.3%) that required immediate intervention due to extraocular muscle entrapment resulting in vasovagal responses, all returned to full and normal extraocular motility. There were 2 postoperative complications without any permanent sequelae; no patient developed postoperative enophthalmos recognizable by both physician and parents, and diplopia improved in all the 6 patients who suffered from immediate postoperative diplopia (10.7%).
Conclusions:
The nylon foil implant is a safe and effective method to repair pediatric orbital wall fractures given the low complication rate.
