Orbital Soft Tissue Displacement After Blow-Out Fracture Repair Using Poly (L-Lactide-Co-Glycolide) Polymer Plates Based on Image Fusion Technique.

PURPOSE: To analyze the displacement of orbital soft tissue after blow-out fracture (BOF) repair with poly (L-lactide-co-glycolide) plates. MATERIALS AND METHODS: In this retrospective study, all patients who had undergone repair operations for orbital BOF from 2017 to 2021 were evaluated. Poly (L-lactide-co-glycolide) plates were used as repair materials. Preoperative and postoperative computed tomography images were integrated into the same coordinate system applying image fusion technique and were compared to determine the maximum displacement of orbital tissue after surgical repair. RESULTS: A total of 15 patients were included. Five were male, and 10 were female. Mean age was 33±16 years. Median waiting period was 18 (12-23) days. Six cases were medial wall fractures, 5 were floor fractures, and 4 were combined fractures. Maxillo-ethmoidal strut was involved in 4. Mean defect area was 176.52±108.48 mm 2 . Median interval between postoperative imaging examinations was 292 (223-600) days. Mean orbital tissue displacement was 2.6±1.8 mm. Using simple and multivariable linear regression analysis, the fracture defect area ( P =0.001) and maxillo-ethmoidal strut involvement ( P =0.013) were found to be significantly associated with orbital tissue displacement. Median orbital volume change was 0.804 (0.647-1.010) cm 3 . Average proptosis variation was 1.2±0.8 mm. CONCLUSIONS: Poly (L-lactide-co-glycolide) plates were more suitable for orbital BOF with small defect size. Those with large defect or maxillo-ethmoidal strut involved might have greater tissue displacements due to decline of supporting strength of poly (L-lactide-co-glycolide) plates.

Long-term infectious complications of using porous polyethylene mesh for orbital fracture reconstruction.

Porous polyethylene is a widely used implants in orbital reconstruction, on which comprehensive clinical analysis, various treatments, and different prognosis according to specific classification principles on long-term complications have not been reported.To investigate the new clinical symptoms, intraoperative findings, treatments, and outcomes of complications long period after previous surgery, resulting from the use of porous polyethylene mesh for orbital fracture reconstruction.A retrospective study was conducted on 21 patients at the Department of Ophthalmology, Shanghai Ninth People's Hospital with orbital complications after orbital fracture reconstruction with porous polyethylene mesh for 4 ±â€Š2.2 years from 2011 to 2013. These data included new clinical symptoms after previous surgery, computerized tomography data, intraoperative findings, treatments, and outcomes.Data from 21 patients were analyzed in this study. Two patients received conservative treatment, while the other 19 patients underwent surgical approaches. Classification principles for orbital complications after orbital wall defect reconstruction with porous polyethylene mesh were formulated according to patients' new clinical symptoms, computed tomography (CT), and intraoperative findings after previous surgery. In the last follow-up, 19 patients (90.5%) were cured or improved according to our assessment principle. The follow-up ranged from 3 to 45 months (35 months in average).According to specific classification for orbital complications resulting from the use of porous polyethylene mesh for orbital fracture reconstruction, various medical treatments should be carried out, and the prognosis may be different.