Patient-specific implants for orbital fracture surgery

Orbital wall fractures are among the most common maxillofacial injuries and require precise reconstruction to restore orbital volume, prevent diplopia, and avoid long-term sequelae such as enophthalmos or facial asymmetry. Traditional reconstruction techniques have relied on autologous grafts and preformed alloplastic implants; however, these approaches are limited by intraoperative variability, imprecise contour restoration, and increased operative time. Over the past decade, the emergence of patient-specific implants (PSIs), designed through advanced three-dimensional (3D) imaging, computer-aided design, and computer-aided manufacturing, has transformed the field of orbital reconstruction. PSIs allow highly accurate anatomical restoration, reduce intraoperative manipulation, and improve clinical outcomes. This review provides a comprehensive overview of the evolution of orbital fracture reconstruction, design and fabrication principles of PSIs, clinical evidence supporting their use, limitations, and future directions, including bioactive materials, artificial intelligence-driven design, and point-of-care 3D printing.