Orbital floor repair with titanium mesh screen

Abstract

Background and objectives: Surgical repair of the acutely fractured orbit strives to restore appearance, preserve ocular and orbital function, and avoid enophthalmos or hypoglobus. Repair is achieved with autologous bone graft, synthetic substitutes, or both. The purpose of this article is to present an alternative procedure--use of implants, cut from a titanium mesh screen, without bone graft.

Method and materials: A total of 51 orbital floor fractures in 43 patients were repaired with titanium mesh screen implants. In three patients with bilateral orbital floor fractures repaired with titanium mesh, intraoperative symmetry was improved with bone graft added to the mesh on one side.

Results and/or conclusions: Follow-up was available for 42 orbits in 35 patients and averaged 9 months. The transconjunctival approach with lateral canthotomy yielded better results than the subciliary approach, which often caused transient scleral show or ectropion. One patient underwent surgery for ectropion following a subciliary approach, and one patient developed a 4-mm enophthalmos. Routine bone grafting is unnecessary, even in large floor defects. Titanium mesh implants are a simple and reliable option for orbital floor repair.