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Im, Park, and Kwak: Long-Term Results of Reconstruction of Orbital Wall Fracture With Resorbable Copolymer Mesh
Original Article

J Korean Ophthalmol Soc 2009;50(7):976-983.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.7.976

Long-Term Results of Reconstruction of Orbital Wall Fracture With Resorbable Copolymer Mesh

Jae Seok Im, MD1, Do Hoon Park, MD2, Ju Young Kwak, MD1

1Department of Ophthalmology, Wallace Memorial Baptist Hospital, Busan, Korea

2Elephant Eye Clinic, Busan, Korea

Address reprint requests to Ju Young Kwak, MD Department of Ophthalmology Wallace Memorial Baptist Hospital #374-75 Namsan-dong, Geumjeong-gu, Busan 609-728, Korea Tel: 82-51-580-1359, Fax: 82-51-512-1354, E-mail: Kwak7513@lycos.co.kr

Received 12 January 2009       Accepted 14 April 2009

Copyright © 2009 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study examined the postoperative long-term results of the reconstruction of orbital wall fracture using Macropore®.

Methods

The long-term results for 10 patients who were diagnosed with orbital wall fracture and received the repair of orbital wall fracture using Macropore®, were examined postoperatively after an average of 23.5 months.

Results

The mean difference in orbital volume between the fractured orbit and the unaffected orbit after an average of 23.5 months postoperatively was 1.01±0.70 cm3 (4.75±2.92%), which slightly increased compared to 0.70±0.52 cm3 (3.26±2.10%) immediately after the operation, although the difference was not statistically significant (p-value=0.190). At the last follow-up, the shape of Macropore® was not observed in 3 out of the 10 patients, and intense ossification was observed at the site of fracture in 6 patients. At the last follow-up, one patient showed 1.5 mm enophthalmos, and the other patients did not show the occurrence of diplopia or the progress of enophthalmos.

Conclusions

According to the long-term results of the reconstruction of orbital wall fracture, Macropore® is considered an implant that produces a safe and satisfactory effect without notable complications.

Keywords: Long term results, Macropore®, Orbital wall fracture

References

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Figure 1.
(A) A postoperative CT scan, coronal section, 2 days after the operation. The plate showed adequate strength to bridge the bony defect in the left eye. The resorption of Macropore® was graded 2 and the degree of bone healing was graded 0 (see arrow). (B) A postoperative CT scan, coronal section, 23 months after the operation. The bone healing took place totally along the fracture line. CT scan showing the part of Macropore® over new growing bone in the left eye. The resorption of Macropore® was graded 1 and the degree of bone healing was graded 2 (see arrow).
jkos-50-976f1.tif
Figure 2.
The orbital volume was calculated by summing the volumes between two scan sections. Preoperative (A) and postoperative (B) CT scans.
jkos-50-976f2.tif
Table 1.
Data on patients with orbital fracture and preoperative findings of patients
Patient No. Sex/Age Eye Type of fracture Gaze restriction∏ Diplopia# Enophthalmos (mm)
1 F*/25 Right Med.‡ (−) (−) 1.0
2 M†/32 Left Inf.§ and Med. (−) (−) 2.0
3 M/25 Left Inf. (−) (−) 1.0
4 M/14 Left Inf. (+)/UP (+) 0
5 M/13 Left Inf. (+)/UP, DW (+) 0.5
6 M/58 Right Inf. (−) (−) 1.0
7 F/45 Right Inf. (+)/UP (+) 0.5
8 F/70 Right Inf. (−) (−) 1.0
9 M/49 Left Inf. (−) (−) 0.5
10 M/46 Right Med. (−) (−) 1.5

(+)/(−)=presence/absence

* Female

† Male

‡ Medial wall

§ Inferior wall

∏ UP=upward, DW=downward

# Clinically significant diplopia.

Table 2.
Postoperative findings of patients
Patient No. Gaze Restriction Early* / Late† Diplopia‡ Early / Late Enophthalmos (mm) Early / Late Follow-up (months)
1 (−) / (−) (−) / (−) 0 / 0 28
2 (−) / (−) (−) / (−) 1.0 / 1.5 26
3 (−) / (−) (−) / (−) 0 / 0 25
4 (−) / (−) (−) / (−) 0 / 0 25
5 (−) / (−) (−) / (−) 0 / 0 23
6 (−) / (−) (−) / (−) 0 / 0.5 23
7 (−) / (−) (−) / (−) 0 / 0 22
8 (−) / (−) (−) / (−) 0.5 / 0.5 22
9 (−) / (−) (−) / (−) 0 / 0 21
10 (−) / (−) (−) / (−) 0.5 / 0.5 20

(+)/(−)=presence/absence

* Within 1 month

† At the last follow-up

‡ Clinically significant diplopia.

Table 3.
Preoperative and postoperative orbital CT scan
Patient No. Preoperative volume*(cm3)(%) Postoperative volume*(cm3)(%)(within 1 week) At the last follow-up
Postoperative volume*(cm3)(%) Implant resorption† Bone growth‡
1 1.45 (7.64) 0.22 (1.32) 0.67 (3.64) 0 2
2 3.27 (13.56) 1.78 (7.23) 2.31 (9.66) 1 2
3 1.51 (7.10) 0.37 (1.77) 0.53 (2.58) 0 2
4 1.23 (5.97) 0.31 (1.54) 0.49 (2.46) 0 2
5 0.45 (2.37) 0.19 (1.06) 0.33 (1.76) 1 2
6 2.44 (10.13) 1.13 (5.02) 1.86 (8.43) 1 2
7 1.41 (8.17) 0.46 (2.48) 0.31 (1.68) 1 1
8 2.12 (10.82) 0.98 (4.78) 1.30 (6.26) 1 1
9 0.77 (4.46) 0.52 (2.30) 0.80 (3.78) 1 1
10 3.44 (16.32) 1.05 (5.10) 1.52 (7.24) 1 1

* Volume expansion of fractured orbits

† Resorption was graded: 0=total, 1=moderate, 2=mild

‡ Bone growth was graded: 0=no, 1=moderate, 2=intense

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