title: Use of bioresorbable implants for orbital fracture reconstruction.
abstract: Bioresorbable implants offer several advantages over permanent implants and serve as a useful alternative in the reconstruction of orbital fractures. Our aim of the study was to evaluate the clinical effectiveness and safety of various bioresorbable implants in the repair of orbital fractures.
  
  
  
  A retrospective review of all patients who had undergone orbital fracture repair with bioresorbable implants in a single tertiary trauma centre from January 2005 to December 2014 was performed. Main outcome measures included improvement in ocular motility, diplopia, enophthalmos and infraorbital hypoaesthesia, as well as complication rates.
  
  
  
  Our study comprised 94 patients and 98 orbits. The types of fractures included orbital floor blow-out fractures (56.1%), zygomaticomaxillary complex fractures (20.4%), combined orbital floor and medial wall fractures (15.3%) and medial wall blow-out fractures (5.1%). The implants evaluated included poly-L/DL-lactide implants (P[L/DL]LA) 85/15 (Rapidsorb), (P[L/DL]LA) 70/30 (PolyMax), polycaprolactone (Osteomesh) and (P[L/DL]LA) 70/30 (MacroPore). There was significant improvement in ocular motility, diplopia, enophthalmos and infraorbital hypoaesthesia postoperatively at week 1, 1 month and 6 months (p<0.001). Comparison of results between the various implants and types of fractures showed no significant difference in postoperative outcome and complications. Late postoperative imaging at 15-24 months showed complete resorption of implants and features of neobone formation in all patients.
  
  
  
  Our experience with bioresorbable implants shows them to be safe and clinically effective in the reconstruction of orbital fractures.
authors.affiliation: Orbit and Oculofacial Surgery, Department of Ophthalmology, National University Hospital Singapore, Singapore, Singapore.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Young
authors.affiliation: Orbit and Oculofacial Surgery, Department of Ophthalmology, National University Hospital Singapore, Singapore, Singapore.
authors.forename: Gangadhara
authors.initials: G
authors.lastname: Sundar
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital Singapore, Singapore, Singapore.
authors.forename: Thiam-Chye
authors.initials: TC
authors.lastname: Lim
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Lang
authors.affiliation: Department of Ophthalmology, National University Hospital Singapore, Singapore, Singapore.
authors.forename: George
authors.initials: G
authors.lastname: Thomas
authors.affiliation: Orbit and Oculofacial Surgery, Department of Ophthalmology, National University Hospital Singapore, Singapore, Singapore.
authors.forename: Shantha
authors.initials: S
authors.lastname: Amrith
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015841:Enophthalmos / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000209:etiology / Q000601:surgery; D009917:Orbital Fractures / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Orbit; Trauma; Treatment Surgery