Is there an ideal implant for orbital reconstructions? Prospective 64-case study

Area of Science:

• Ophthalmology
• Biomaterials Science
• Plastic Surgery

Background:

• Orbital reconstructions are crucial for restoring function and aesthetics after trauma or surgery.
• Choosing the optimal implant material is essential for successful outcomes.
• Large orbital defects (>1 cm) present unique reconstructive challenges.

Purpose of the Study:

• To compare the effectiveness of porous polyethylene, titanium mesh, and castor oil-derived biopolymer for orbital reconstructions.
• To evaluate postoperative outcomes including diplopia, enophthalmos, ocular motility, and infraorbital nerve paraesthesia.
• To assess surgeon-reported ease of handling and implant stability.

Main Methods:

• A randomized study involving 63 patients (64 orbits) with large orbital wall defects.
• Patients were allocated to receive porous polyethylene, titanium mesh, or castor oil-derived biopolymer implants.
• Preoperative and postoperative assessments included clinical evaluation and surgeon feedback.

Main Results:

• All tested materials effectively reconstructed orbital volume, regardless of defect size.
• Significant reductions in enophthalmos, diplopia, and ocular motility issues were observed postoperatively.
• Only 10 patients experienced complications, with just one requiring material removal.

Conclusions:

• Porous polyethylene, titanium mesh, and castor oil-derived biopolymer are effective for orbital reconstruction.
• These materials demonstrate favorable handling characteristics and provide stable reconstructions.
• The study supports the use of these biomaterials for managing large orbital defects.