Orbital wall fracture repair using Seprafilm.
OBJECTIVE
Seprafilm is a hybrid product of carboxymethylcellulose and sodium hyaluronate that can act as an absorbable barrier to decrease the formation and severity of postoperative adhesions in abdominal, thoracic, and pelvic surgeries. The authors report their experience with use of Seprafilm in "trap door" orbital wall fracture repair.


METHODS
Retrospective case series of 4 consecutive patients with trap door orbital wall fractures secondary to blunt trauma with entrapped orbital soft tissue who underwent surgical repair with placement of Seprafilm implant in 2008. Orbitotomy was performed via standard transconjunctival and/or transcaruncular approaches with release of entrapped tissues, and placement of Seprafilm implant over the fracture site without fixation. Patients were followed for at least 6 months. Ophthalmic and orbital examinations, including ocular motility and Hertel exophthalmometry measurements, were recorded.


RESULTS
All 6 orbital wall fractures (4 floor, 2 medial wall) were successfully corrected with resolution of restrictive motility in the follow-up period (average 10 months; range 6 months to 1.5 years). Mean patient age was 13.5 years (range, 9-20 years). Two of the 4 patients had 2 separate fractures. There were no complications and no need for reoperation.


CONCLUSIONS
Seprafilm may have a role in reconstruction of the "trap door" type of orbital wall fractures. The ease of use, lack of fixation, and absorbable properties without inflammation are encouraging for further study.
Taban
Mehryar
M
Department of Orbital and Plastic Reconstructive Surgery, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-7006, USA.
Nakra
Tanuj
T
Mancini
Ronald
R
Douglas
Raymond S
RS
Goldberg
Robert A
RA
D000293:Adolescent; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid; D008297:Male; D008567:Membranes, Artificial; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000517:prevention & control; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications; D055815:Young Adult
D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid