Outcome of Orbital Wall Reconstruction with the Use of Titanium Implants

Abstract

Purpose: To study the outcomes of orbital wall fracture repair by using titanium mesh for orbital wall reconstruction.

Methods: A retrospective review of patient records was performed for 13 patients with orbital wall reconstruction surgery done from August 2011 through April 2016 between 2 hospitals. Orbital wall reconstruction was performed using orbital titanium plate fixed at the inferior orbital rim with screws. Surgical outcomes including improvement in diplopia, ocular motility, maximal residual ocular restrictions, and complications were recorded. Results: This retrospective case series includes 13 patients (12 male and 1 female) with ages ranging from 20-56 years old (mean age, 36 years old). The series included 12 out of 13 (92.3%) of the patients with orbital wall blowout fractures involving at least 1 orbital wall; 1 out of 13 (7.7%) required reconstruction after tumor resection. Postoperative diplopia improved in 10 cases (76.9%), stayed the same in 2 cases (15.4%), and worsened in 1 case (7.7%). Similarly, ocular motility improved in 10 cases (76.9%) and worsened in 3 cases (23.1%). Postoperatively, there was residual diplopia on up-gaze in 10 cases, none in down-gaze, lateral gaze diplopia in 2 cases, and medial gaze diplopia in 3 cases. No intraoperative or postoperative complications were noted in any of the cases. Conclusions: The use of titanium plate in orbital reconstruction surgery was found to be safe with a low complication rate and produced satisfactory postoperative outcomes. There was improvement in ocular motility and subjective diplopia in most cases. The most common residual symptom was diplopia on up-gaze.