Related Experiment Video
Updated: Jan 12, 2026
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Patient-Specific Implants in Post-traumatic Orbital Reconstruction: A Systematic Review
Michael V Joachim1, Farangis Farsio2, Michael R Markiewicz3
1Senior Faculty, Department of Oral and Maxillofacial Surgery, Gray Faculty of Medical and Health Sciences, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel; Attending Surgeon, Unit of Oral and Maxillofacial Surgery, Shamir (Assaf ha-Rofeh) Medical Center, Tzrifin, Israel.
Background:
Orbital fractures commonly result in functional and esthetic deficits, demanding precise reconstruction of orbital volume and globe position. Patient-specific implants (PSIs) have emerged as promising solutions, yet their definitive clinical and cost-effectiveness benefits remain debated.
Purpose:
The study purpose was to estimate and compare orbital volume restoration, globe position, functional outcomes, and complications between PSI versus conventional orbital reconstruction.
Study Selection:
A systematic search of PubMed, Embase, Cochrane Library, and Web of Science from inception to May 2025 identified studies comparing PSIs with conventional orbital reconstruction techniques in adults with post-traumatic orbital defects. Studies exclusively reporting technical aspects, pediatric samples, or nontraumatic defects were excluded. Of 385 identified studies, 23 met the inclusion criteria.
Results:
The included studies involved 1,222 subjects. PSIs demonstrated significantly better orbital volume restoration compared to conventional methods (mean volume difference: PSI, 0.73 ± 0.28 cm3; conventional, 1.54 ± 0.38 cm3, P < .05). Globe position outcomes were also consistently better in PSI groups, with significantly reduced persistent enophthalmos (PSI 7.3% vs conventional 18.2%, P = .03). Functional outcomes, specifically persistent diplopia, were significantly lower with PSI (PSI 11.7% vs conventional 30.1%, P = .01). Revision rates were also significantly reduced with PSI usage (PSI 5.9% vs conventional 13.7%, P = .01). Despite higher initial costs, PSI reduced operative times by an average of 15.7 minutes, which may offset overall treatment expenses.
Conclusions And Relevance:
PSIs offer superior outcomes in orbital volume restoration, globe positioning, and reduced complication and revision rates compared to conventional reconstruction. These findings strongly support PSI utilization in complex post-traumatic orbital reconstruction, particularly when integrated with intraoperative navigation systems. Further research, especially prospective randomized studies with long-term follow-up, is needed to strengthen these recommendations.
