Comparison of surgical outcomes of large orbital fractures reconstructed with porous polyethylene channel and porous polyethylene titan barrier implants

Purpose: To compare the postoperative outcomes of large orbital fractures repaired with porous polyethylene (PP) channel implants (PPCIs) and PP titan barrier implants (PPTBs). Methods: Medical records of 42 patients who underwent surgical reconstruction for a large orbital fracture with either PPCI or PPTB were reviewed retrospectively. The degree of diplopia, determined with a binocular single vision test, and enophthalmos, measured by a Hertel exophthalmometer, was compared between 2 implant groups. Orbital volumes were calculated using CT scans and the measuring tool. Results: Of the 42 patients examined, 16 received PPCI and 26 received PPTB. No significant difference in the degree of diplopia was observed between the 2 implant groups before surgery, and 1 and 3 months after surgery (p = 0.256, 0.408, and 0.432, respectively). Preoperative average enophthalmos measuring 1.28 mm and 1.04 mm was successfully corrected to 0.19 mm and 0.25 mm 3 months after reconstruction with PPCI and PPTB, respectively. The fractured orbit volumes and nonfractured contralateral orbit volumes were 24.96 ± 2.32 cm and 23.18 ± 1.73 cm in the PPCI group, and 26.80 ± 2.10 cm and 24.13 ± 2.28 cm in the PPTB group, respectively. After surgery, the fractured orbit volumes significantly decreased to 23.39 ± 2.82 cm in the PPCI group and to 23.53 ± 1.74 cm in the PPTB group; these values were not significantly different from that of the nonfractured orbit (p = 0.681 for PPCI and 0.204 for PPTB). Conclusions: Porous polyethylene channel implant and PPTB are both effective implant materials for the repair of large orbital fractures; however, PPTB has the additional benefit of not requiring screw fixation.