Repair of Orbital Floor Fractures Using Bioresorbable Poly-L/DL-Lactide Plates

Abstract

To assess the long-term clinical and radiologic findings after insertion of a bioresorbable polylactide plates P(L/DL)LA 70/30 implant (PolyMax) in the repair of orbital floor and wall defects, with special focus on stability and clinical signs of foreign-body reaction. Forty-six patients who had orbital blowout fractures with at least 1.5-cm(2) bone defects in 1 or 2 walls were included in this retrospective study. Each defect was reconstructed within 2 weeks of injury using a triangle form plate of polylactide. Computed tomography (CT) was performed before the operation and 1 year postoperatively. In 17 patients, additional CT was performed within 2 to 3 years postoperatively. Clinical assessments were performed preoperatively and at 3-, 6-, and 12-month intervals postoperatively. None of the patients showed clinical foreign-body reactions. There was no evidence of infection. Diplopia was seen in 6 patients 3 months postoperatively but normalized in 5 patients at 6 months. Mild enophthalmos was seen in 2 patients postoperatively at 1 year. No sagging of the reconstructed area was found on CT. The P(L/DL)LA 70/30 implant is a well-tolerated, reliable material in orbital repair of relatively large defects. The bioresorbable plate leaves a stable bridge of healed bone or soft tissue after complete degradation.