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Orbital reconstruction using porous polyethylene sheets

P A Rubin1, J R Bilyk, J W Shore

  • 1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.

Ophthalmology
|October 1, 1994
PubMed
Summary
This summary is machine-generated.

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High-density porous polyethylene sheets are effective for orbital reconstruction, improving diplopia and enophthalmos with few complications. These implants offer excellent handling and predictable results in reconstructive surgery.

Area of Science:

  • Ophthalmology
  • Plastic Surgery
  • Biomaterials Science

Background:

  • Growing interest in porous alloplastic implants for orbital reconstruction due to enhanced biocompatibility.
  • High-density porous polyethylene (Medpor) is a commercially available option with interconnecting pores and excellent handling characteristics.
  • Medpor is composed of pure polyethylene particles, facilitating its use in complex surgical scenarios.

Observation:

  • 37 orbital reconstructions were performed using porous polyethylene sheets (0.85-, 1.5-, or 3-mm).
  • Mean follow-up was 18.5 months, with reconstructions addressing internal orbital defects, anophthalmic enophthalmos, and spontaneous enophthalmos.
  • Implants were utilized in conjunction with other materials like miniplates, silastic sheets, autologous bone, or nasal septal cartilage when necessary.

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Findings:

  • Postoperative diplopia resolved in 15 patients and decreased in 7, with no induced or exacerbated diplopia.
  • Enophthalmos resolved in 9 of 18 patients, and hypoglobus was normalized in all nine patients treated for it.
  • A single major complication of orbital infection required explantation; minor complications included undercorrection and palpable implants.

Implications:

  • Porous polyethylene sheets provide significant advantages for orbital reconstruction, including ease of handling, shaping, and fixation.
  • These implants allow for stable and predictable surgical outcomes with a low complication rate.
  • The versatility of porous polyethylene sheets makes them a valuable tool for various orbital reconstructive procedures.