Orbital floor reconstruction using porous polyethylene with embedded titanium mesh / Omar Mahmoud Solyman ; Supervised Ayman Fawzy Elshiaty , Hisham Ali Hashim , Sameh Hassan Abdelbaky

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Ophthalmology

Purpose: To evaluate safety and efficacy of high density porous polyethylene with embedded titanium mesh in the reconstruction of orbital floor after orbital floor fractures. Methods: Interventional case series study of twenty patients who underwent orbital floor reconstructions using 1.0-mm high density porous polyethylene with embedded titanium mesh (Medpor Titan Barrier sheets) for the repair of orbital floor fracture. A transconjunctival approach was used in 16 patients, subciliary incision in 3 cases and infraorbital approach in one case. Patients were examined one day and one week postoperative for early postoperative complications. At 3rd and 6th months postoperative follow up visits, patients were assessed for enophthalmos, diplopia, and any potential complication. Results: All twenty patients had improved diplopia and/or enophthalmos relative to their preoperative condition. The diplopia resolved in 11 patients (78.57%) and improved in the remaining 3 patients of 14 patients with pre-operative significant diplopia. Enophthalmos was corrected to within 2 mm of the opposite eye in seven of nine cases(77.77%) and was improved in the remaining two cases. There was no postoperative diplopia worse than before surgery. Also there was no volume overcorrection resulting in proptosis. No major complication with potential loss of vision, implant infection, or migration was noted over 6 months of follow up. Complications included lower lid ectropion in one case, infraorbital hypoesthesia in another patient, lower lid retraction in two cases and palpable implants in two cases

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