Effectiveness of operative treatment of internal orbital wall fracture with polydioxanone implant

Many implants, some made from teflon or silicone, have been used for intern al orbital wall reconstruction. Late complications relating to use of such implants have been reported. In this prospective study a polydioxanone (PDS) implant absorbable in vivo was used for internal orbital wall reconstruction. Follow-up involved clini cal examination, magnetic resonance imaging (MRI) and computerized tomograp hy (CT). Clinical examinations were undertaken before operation and up to 3 6 weeks postoperatively. Sixteen consecutive patients (10 pure blow-out fra ctures. six with associated zygomatic fracture) took part in the study. Pre valences of diplopia, proptosis and enophthalmus were recorded during each follow-up examination. This study revealed no muscle entrapment within the fracture line. Although CT results confirmed bone growth in the internal orbital wall, shape was u nsatisfactory, and orbital volume was not reduced. MR[ revealed thick scar formations in six cases (37.5%), fibrotic sinuses filled with air or gas in three cases (19%) and a fibrotic sinus with fluid around the PDS in one ca se (6%). Our results suggest that use of PDS in reconstructing the internal orbital wall is inadvisable.