Selection of Materials for Orbital Floor Reconstruction

A clinically significant orbital floor defect will be defined as a gap remaining after reduction or elevation of orbital floor fracture fragments that requires a semirigid implant to avoid postoperative enophthalmos or orbital dystopia. Therefore, this definition excludes small defects (,5 mm in width) where Gelfilm (Pharmacia and Upjohn Inc, Kalamazoo, Mich) or fascia could be used without the need for rigid or semirigid support of the orbital contents. Fractures involving the orbit are relatively common in individuals with facial trauma because of the prominence of the globe and periorbital region. Inadequate reduction and reconstruction can result in substantial disturbances in function and appearance if the preinjury eye position has not been restored. Treatment of orbital floor fractures aims to prevent longterm sequelae, especially enopthalmos, persistent diplopia, and orbital dystopia, by reconstructing large floor defects and preventing herniation of orbital contents into the maxillary sinus. No consensus exists on the choice of implant materials for orbital reconstruction, and a plethora of materials is currently available and used depending on individual surgeons’ preferences. The materials currently used can be broadly categorized as autologous, allogenic, and alloplastic. A list of some of these materials appears below: