A comparative study of porous polyethylene versus absorbable polydextro- and polylevolactic-lactide plate in reconstruction of isolated medial orbital wall fracture

J Plast Reconstr Aesthet Surg. 2022 Feb;75(2):782-787. doi: 10.1016/j.bjps.2021.08.023. Epub 2021 Sep 17.

Abstract

Background: Several materials for medial orbital wall reconstruction have been mentioned in the literature. Our main purpose was to investigate postoperative enophthalmos and diplopia after medial orbital wall reconstruction with polydextro- and polylevolactic (poly-L/DL) acid (P[L/DL]LA) mesh plates and porous polyethylene plates.

Methods: Using a retrospective study design, we enrolled a cohort of isolated medial blowout fracture patients treated during a 58-month interval. The predictor variable was medial orbital wall reconstruction materials (P(L/DL)LA mesh plate and porous polyethylene plate. The main outcome variables included the occurrence of postoperative enophthalmos and diplopia at 1 week, 1, 3, 6, and 12 months post-surgery. Appropriate descriptive, uni- and bivariate statistics were computed, and P < 0.05 was considered significant.

Results: Three hundred-two isolated medial blowout fracture patients were included (24.5% females, 67% treated with P(L/DL)LA mesh plate). Exophthalmos measured highest in both groups 1 week after surgery and decreased steadily for 6 months postoperatively. Statistically significant differences were observed between both groups at 1 week, 1 month, and 3 months after surgery, with a higher incidence of exophthalmos observed in the P(L/DL)LA mesh plate group (P < 0.001). No significant differences were observed at 6 and 12 months after surgery.

Conclusion: The occurrence of enophthalmos after medial blowout fracture reconstruction with P(L/DL)LA mesh plate is comparable with the use of porous polyethylene plate. Both P(L/DL)LA mesh and porous polyethylene plates are, therefore, reliable implants for medial orbital wall reconstruction.

Keywords: Absorbable implant; Orbital fracture; Polydextro- and polylevolactic acid; Polyethylene; Reconstruction.

MeSH terms

  • Dioxanes
  • Diplopia / etiology
  • Enophthalmos* / etiology
  • Exophthalmos* / complications
  • Exophthalmos* / surgery
  • Female
  • Humans
  • Male
  • Orbital Fractures* / complications
  • Orbital Fractures* / surgery
  • Plastic Surgery Procedures* / adverse effects
  • Polyethylene
  • Porosity
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Dioxanes
  • Polyethylene
  • dilactide