title: Orbital fracture repair outcomes with preformed titanium mesh implants and comparison to porous polyethylene coated titanium sheets.
abstract: BACKGROUND
  Restoration of orbital volume after internal orbital fractures can prevent enophthalmos. A variety of allografts are commonly used including titanium mesh with and without porous polyethylene coating. Some controversy exists over the use of uncoated titanium mesh in the orbit. Newer products contoured to the three dimensional orbital anatomy aim to improve reestablishment of the complex orbital shape though studies of outcomes with their use are limited.
  
  
  METHODS
  A retrospective chart review was performed to evaluate surgical outcomes in all patients who underwent orbital fracture repair with DePuy/Synthes titanium MatrixMIDFACE prefabricated implants (PFTi) as compared with porous polyethylene/titanium hybrid implants (PPETi) including Stryker Medpor Titan, MTB, and BTB implants. Incidence of reoperation, diplopia, and movement restriction between PFTi and PPETi groups and the risk ratio of the above outcomes between implant types were compared.
  
  
  RESULTS
  A total of 464 orbital implants were reviewed. Patients were divided by implant type with 195 patients receiving a PFTi implant and 269 patients receiving PPETi implant. (PFTi) and 269 had placement of a porous polyethylene/titanium hybrid implant. Despite statistically significant increased probability of utilization in more complex and delayed fractures, the PFTi implant showed no significant difference in complication profile or reoperation rate compared to the more commonly used PPETi.
  
  
  CONCLUSIONS
  PFTi implants, designed to replicate the native orbital shape, have similar surgical outcomes and no difference in complication profile compared to standard porous polyethylene/titanium implants hybrid plates.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Peng
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Shannath L
authors.initials: SL
authors.lastname: Merbs
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Grant
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA. Electronic address: nick.mahoney@jhmi.edu.
authors.forename: Nicholas R
authors.initials: NR
authors.lastname: Mahoney
mesh_terms: D000328:Adult; D001860:Bone Plates; D005260:Female; D006801:Humans; D008297:Male; D009917:Orbital Fractures / Q000601:surgery*; D020959:Polyethylene; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013526:Surgical Mesh; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D020959:Polyethylene; D014025:Titanium
keywords: Custom implants; Custom orbital implants; Orbital fracture; Orbital fracture repair; Orbital implants; Preformed orbital implants