Fenestration of Solid Orbital Implants: Reducing Retrobulbar Hematoma Rate

Area of Science:

• Ophthalmology
• Plastic Surgery
• Trauma Surgery

Background:

• Retrobulbar hematoma is a rare but serious complication after orbital fracture repair.
• Solid porous polyethylene implants are commonly used for orbital reconstruction.

Purpose of the Study:

• To evaluate the incidence of retrobulbar hematoma in patients undergoing orbital fracture repair with fenestrated versus nonfenestrated implants.
• To determine if implant fenestration reduces the risk of postoperative retrobulbar hematoma.

Main Methods:

• Retrospective chart review of 104 patients who underwent orbital fracture reconstruction with implants between 2006 and 2016.
• Data collected included patient demographics, implant type (fenestrated or nonfenestrated), and occurrence of retrobulbar hematoma.

Main Results:

• One case of non-surgical retrobulbar hematoma occurred in a patient with a nonfenestrated implant; it resolved spontaneously without sequelae.
• No retrobulbar hematomas were observed in patients who received fenestrated implants.

Conclusions:

• Fenestration of solid implants for orbital reconstruction is a straightforward procedure.
• Implant fenestration may decrease the incidence of postoperative retrobulbar hematoma following orbital fracture repair.