Medpor porous polyethylene implants in orbital blowout fracture repair

Purpose Various materials are used in orbital blowout fracture repair. We d escribe a series of patients with orbital blowout fractures that were repai red using porous polyethylene (Medpor) sheets. Methods A non-comparative interventional case series is described of 30 blo wout fractures of 30 patients aged 7-60 years (median 29 years) who underwe nt orbital blowout fracture repair with Medpor sheets. The mean follow-up w as 19.1 months (minimum 5 months). The indication for surgery in 6 cases wa s non-resolving diplopia. The remaining 24 cases had surgery for enophthalm os. Ten cases underwent primary or secondary hydroxyapatite orbital implant ation at the same time as orbital floor blowout fracture repair. Data were collected on postoperative motility and diplopia, enophthalmos, cosmesis, c omplications and re-operations. Results In no case was diplopia worsened by blowout fracture repair. Where surgery was performed for the correction of enophthalmos, late surgery did not compromise the surgical results. There were no intraoperative complicat ions. The one major complication was a case of recurrent implant infections leading to implant removal. There were 3 minor postoperative complications : 2 cases of postoperative infraorbital anaesthesia and one case of a palpa ble titanium screw. Re-operations were performed for pre-existent diplopia, lid laxity, socket abnormalities and mid-facial deformities. None of these arose from the blowout fracture repair. Conclusions The study suggests that in orbital blowout fracture repair Medp or implants are safe and effective with few complications. Late surgery for enophthalmos is technically more difficult but is not associated with poor er functional or cosmetic results.