Reconstruction of Orbital Floor Fractures Using Porous Polyethylene with Embedded Titanium Mesh

Purpose: To evaluate safety and efficacy of porous polyethylene with embedded titanium mesh in the reconstruction of fractured orbital floors.Methods: Interventional case series study of twenty patients who underwent orbital floor reconstructions using 1.0-mm thick porous polyethylene with embedded titanium mesh for the repair of orbital floor fractures. A transconjunctival approach was used in 16 patients, subciliary incision in 3 cases and subtarasal approach in one case. Patients were followed-up for ocular projection, diplopia, and any complications.Results: All twenty patients had improved diplopia and/or enophthalmos relative to their preoperative condition. Diplopia resolved in 11 patients (78.57%) and improved in the remaining 3 patients of 14 patients with pre-operative significant diplopia. Enophthalmos was corrected to within 2mm of the opposite eye in seven out of nine cases (77.77%) and improved in the remaining two cases. There was no postoperative diplopia worse than before surgery. Also there was no volume overcorrection resulting in proptosis. No major complication with potential loss of vision, implant infection, or migration was noted over 6 months of follow-up. Complications included lower lid ectropion in one case, infraorbital hypoesthesia in another patient, lower lid retraction in two cases and palpable screw in two cases.Conclusion: Porous polyethylene with embedded titanium mesh is safe and highly effective in the reconstruction of orbital floor in cases of orbital floor fractures that provided intraoperative rigid fixation and stable structural support over 6 months postoperative follow-up period.