[Lactic acid polymer implants in the repair of traumatic defects of the orbital floor]. / Intérêt des implants en polymères d'acide lactique dans la réparation des pertes de substance traumatiques du plancher de l'orbite.

ABSTRACT

BACKGROUND: The criteria determining the choice of the technique used to repair traumatic orbital floor defects include the quality of the expected result, morbidity, ease of use and plasticity of the method, and its cost and availability. Among the different methods proposed, lactic acid polymer implants are particularly interesting. MATERIAL AND METHODS: Eighteen patients with an isolated blow-out fracture of the orbital floor were treated with a lactic acid polymer implant between 1995 and 1996. Ten of these patients were reviewed at 24 to 43 months follow-up. RESULTS: The mean age of the patients was 35 years (20-52 years). No residual diplopia was observed. None of the patients had an anomalous orbital volume or ocular dystopia. None of the implants migrated. One patient experienced episodes of palpebral inflammation that resolved spontaneously. The ten patients reviewed were satisfied with the outcome. DISCUSSION: The properties of lactic acid polymer implants facilitate their use, avoid morbidity and provide a quality result. This is the procedure of choice for repairing tissue loss of the orbital floor. It has several advantages over alternative methods (the implants are rigid, thin, resorbable and well tolerated) without having their defects (thickness, fragility, roughness, predetermined form, rapid alteration, specific instrumentation, iatrogenic disorders). In addition, lactic acid polymer plates can be remodeled when heated, allowing a precise adaptation of the implant to the orbital structures. Finally, the cost, compared with the advantages, is not a barrier for routine use.