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Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
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Patient-Specific Orbital Implants Vs. Pre-Formed Implants for Internal Orbital Reconstruction
Daphna Landau Prat1,2,3,4, Said Massarwa5, Assa Zohar1
1Orbital Ophthalmic Plastic & Lacrimal Surgery Institute, Goldschleger Eye Institute, Sheba Medical Center Tel Hashomer, Israel.
Seminars in Ophthalmology
|January 14, 2023
Summary
Patient-specific implants (PSI) may offer better outcomes than pre-formed implants (PFI) for orbital blowout fractures, potentially reducing enophthalmos and asymmetry. Both implant types provide good results for fracture repair.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Biomaterials
Background:
- Orbital blowout fractures are common injuries requiring surgical repair.
- Implant selection is crucial for restoring orbital volume and function.
- Pre-formed porous polyethylene implants (PFI) and patient-specific implants (PSI) are used in orbital reconstruction.
Purpose of the Study:
- To compare the outcomes of orbital blowout fracture repair using pre-formed porous-polyethylene titanium implants (PFI) versus patient-specific porous-polyethylene implants (PSI).
Main Methods:
- A retrospective cohort study analyzed 27 patients who underwent orbital blowout fracture repair.
- Data collected included baseline characteristics, ophthalmic examination results, ocular motility, fracture type, surgery timing, implant type, and final enophthalmos.
- Patients were divided into PFI (n=16) and PSI (n=11) groups, with a mean follow-up of 1.1 years.
Main Results:
- Both PFI and PSI groups showed significant improvement in diplopia after surgery (P=.03).
- Relative enophthalmos improved in both groups, with PSI showing a trend towards less postoperative enophthalmos and globe asymmetry (-1.1 mm vs -1.7 mm).
- Outcomes were not influenced by factors like previous surgery, age, sex, or fracture complexity.
Conclusions:
- Both PSI and PFI are effective for orbital blowout fracture repair, yielding good outcomes.
- PSI may be a favorable alternative to PFI, potentially offering reduced enophthalmos and globe asymmetry, especially in extensive fractures.
- Despite potential disadvantages like longer production times, PSI's customized design may be beneficial for complex orbital reconstructions.
