Use of enophthalmic implants in the repair of orbital floor fractures.
BACKGROUND
High-density porous polyethylene (Medpor) enophthalmic implants are used in patients with the sunken socket syndrome to augment the orbital volume. We have used them to improve enophthalmos and hypoglobus in the repair of large long-standing orbital floor fractures. This is the first report of enophthalmic wedge implants being used in seeing eyes to improve function and cosmesis.


METHODS
Four patients had large long-standing orbital floor fractures with subsequent enlargement/expansion of the orbital volume. Indications for surgical intervention were enophthalmos (> 2 mm), hypoglobus (> 2 mm) and diplopia in primary position and downgaze. A transconjunctival approach was used to access the orbital floor and a Medpor enophthalmic wedge implant was placed postero-inferiorly to the globe and periosteum.


RESULTS
Patients were followed up for a minimum of 4 to 6 months post-operatively with no complications noted. All patients achieved a good cosmetic and functional result post-operatively with resolution of their enophthalmos and hypoglobus. Diplopia in primary position was corrected with only mild residual diplopia present in extreme up-gaze.


CONCLUSIONS
We have found enophthalmic implants useful in the surgical repair of symptomatic long-standing orbital floor fractures.
Kempster
R
R
Department of Ophthalmology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, UK.
Beigi
B
B
Galloway
G D
GD
D000328:Adult; D000368:Aged; D015841:Enophthalmos / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009917:Orbital Fractures / Q000601:surgery*; D020273:Orbital Implants; D011095:Polyethylenes; D016896:Treatment Outcome
C084562:Medpor; D011095:Polyethylenes