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Use of bioresorbable implants for orbital fracture reconstruction
  1. Stephanie M Young1,
  2. Gangadhara Sundar1,
  3. Thiam-Chye Lim2,
  4. Stephanie S Lang3,
  5. George Thomas4,
  6. Shantha Amrith1
  1. 1Orbit and Oculofacial Surgery, Department of Ophthalmology, National University Hospital Singapore, Singapore, Singapore
  2. 2Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital Singapore, Singapore, Singapore
  3. 3Singapore National Eye Centre, Singapore, Singapore
  4. 4Department of Ophthalmology, National University Hospital Singapore, Singapore, Singapore
  1. Correspondence to Dr Gangadhara Sundar, Department of Ophthalmology, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228, Singapore; gsundar1{at}yahoo.com

Abstract

Purpose Bioresorbable implants offer several advantages over permanent implants and serve as a useful alternative in the reconstruction of orbital fractures. Our aim of the study was to evaluate the clinical effectiveness and safety of various bioresorbable implants in the repair of orbital fractures.

Methods A retrospective review of all patients who had undergone orbital fracture repair with bioresorbable implants in a single tertiary trauma centre from January 2005 to December 2014 was performed. Main outcome measures included improvement in ocular motility, diplopia, enophthalmos and infraorbital hypoaesthesia, as well as complication rates.

Results Our study comprised 94 patients and 98 orbits. The types of fractures included orbital floor blow-out fractures (56.1%), zygomaticomaxillary complex fractures (20.4%), combined orbital floor and medial wall fractures (15.3%) and medial wall blow-out fractures (5.1%). The implants evaluated included poly-L/DL-lactide implants (P[L/DL]LA) 85/15 (Rapidsorb), (P[L/DL]LA) 70/30 (PolyMax), polycaprolactone (Osteomesh) and (P[L/DL]LA) 70/30 (MacroPore). There was significant improvement in ocular motility, diplopia, enophthalmos and infraorbital hypoaesthesia postoperatively at week 1, 1 month and 6 months (p<0.001). Comparison of results between the various implants and types of fractures showed no significant difference in postoperative outcome and complications. Late postoperative imaging at 15–24 months showed complete resorption of implants and features of neobone formation in all patients.

Conclusion Our experience with bioresorbable implants shows them to be safe and clinically effective in the reconstruction of orbital fractures.

  • Orbit
  • Trauma
  • Treatment Surgery

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Footnotes

  • This article was presented as a free paper at the American Academy of Ophthalmology Annual Meeting, 2015.

  • Contributors All authors have made substantial contributions to the (1) conception of the work, (2) the acquisition, analysis or interpretation of data, (3) drafting the work or revising it critically for important intellectual content and (4) final approval of the version published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The manuscript has been read and approved by all the authors, and the requirements for authorship as stated above have been met.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Institutional Review Board (National Healthcare Group).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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