A New Approach in Management of Orbital Adherence Syndrome

Area of Science:

• Ophthalmology
• Plastic Surgery
• Traumatology

Background:

• Orbital wall fractures are common (~40%) midface injuries, frequently involving the inferior and medial walls.
• These fractures alter orbital anatomy, volume, and can lead to enophthalmos, diplopia, and impaired ocular motility.
• Current gold standard treatment involves surgical reconstruction, often using titanium mesh orbital plates.

Purpose of the Study:

• To evaluate and compare the outcomes of orbital reconstruction using traditional orbital mesh versus customized smooth-surfaced titanium orbital implants.
• To investigate the efficacy of smooth-surfaced implants in preventing postoperative complications such as orbital adherence syndrome.

Main Methods:

• Retrospective analysis of orbital reconstructions performed with orbital mesh and customized smooth-surfaced titanium implants.
• Surgical approaches included transconjunctival, subciliary, and coronal methods.
• Assessment of postoperative complications, including implant positioning and orbital adherence syndrome.

Main Results:

• Customized smooth-surfaced titanium implants demonstrated favorable outcomes in orbital reconstruction.
• A reduced incidence of orbital adherence syndrome was observed with smooth-surfaced implants compared to porous titanium mesh.
• Both implant types were effective in restoring orbital wall support, but smooth implants offered improved functional results.

Conclusions:

• Customized smooth-surfaced titanium orbital implants represent a promising alternative to traditional titanium mesh for orbital reconstruction.
• The use of smooth implants may mitigate risks associated with orbital adherence syndrome, improving patient outcomes.
• Further research is warranted to fully elucidate the long-term benefits and indications for smooth-surfaced implants in managing orbital fractures.