Porous polyethylene reconstruction of orbital floor and roof defects – clinical and radiological evaluation

Abstract

Aim: The aim of this study was to evaluate clinically and radiologically the use of high porous polyethylene (Medpor) for reconstruction of post-traumatic orbital roof and floor defects. Patients: 37 patients had traumatic orbital wall defects were studied. Patients were classified into three groups. Group (A) included 22 patients had orbital floor defects. Group (B) included 10 patients had orbital roof defects. Group (C) included 5 patients had combined orbital roof and floor defects. All defects were reconstructed by medpor. Patients were followed by CT scan and by serial MRI. Results: Near all presentations improved in the immediate postoperative period and maintained in the postoperative follow-up period. Neither extrusion nor infection was recorded in any case. Enhancement was detected in the implants by MRI as early as one month post operative in 23 patients and 1.5 months postoperative in the remaining 14 patients. Conclusion: Porous polyethylene was found to be flexible, strong, porous and is highly biocompatible. Its porosity enables vascular and bony ingrowth leading to tissue adhesion and a reduced risk of infection. The current study is the first one described in humans to detect vascular ingrowth into medpor orbital sheets utilizing Gadolinium enhanced MRI. Porous polyethylene sheets was shown to have very favorable results in orbital wall reconstruction.