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

Abstract

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. 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. 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. 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.