Repair of Large Posterior Inferior Wall Fracture Using Medpor(R) Channel Sheet Implant

ABSTRACT

PURPOSE: To evaluate the effectiveness of a Medpor(R) (porous polyethylene) channel sheet in large posterior and inferior orbital wall fracture repair. METHODS: We retrospectively analyzed the clinical features and postoperative outcomes of 52 patients who had undergone orbital wall reconstruction with a Medpor(R) (porous polyethylene) channel sheet between February 1999 and December 2005. RESULTS: Among 52 patients, 44 were men and 8 were women, with average age of 30.8 years and average follow-up period of 6.3 months. The surgery was performed on average at15 days after injury in 44 patients, except for in 8 reoperated cases. Miniplate or microplate fixation on the orbital rim with a Medpor(R) channel was required in all 52 patients for large posterior inferior wall fracture. Preoperatively, 43 patients had symptomatic diplopia, which resolved completely in 32 patients and decreased in 11 following surgery. No patients had induced diplopia or exacerbation of preoperative diplopia, except the primary gaze of 2 patients with hypertropia remained, requiring strabismus correction. The mean difference in preoperative enophthalmos between both eyes was 2.8 mm, which improved to 0.8 mm at the last follow-up. There were no instances of orbital infection, implant exposure or migration, or visual loss during follow-up. CONCLUSIONS: Medpor(R) channel implant provided optimal reconstruction of large inferior orbital wall fracture with posterior defect that lacked structural support.