Degrees of Tolerance in Post-Traumatic Orbital Volume Correction: The Role of Prefabricated Mesh

Treatment with individual orbital wall implants in humans – 1-Year ophthalmologic evaluation

“…Furthermore, they concluded that individual pre-bent titanium mesh is the correct choice of implant material to regain precise volume of the orbit in both recent and older fractures (Guo et al, 2009). One of the most important aspects that should be considered in the discussion is the problem of predicting treatment outcome (Andrades et al, 2009). Clinical evaluation significantly correlated with CT mesh placement, but there was no correlation between clinical evaluation and any of the variables measured on CT.…”

“…There are several scientific centres that routinely use individual titanium implants for orbital wall fractures Schön et al, 2006;An et al, 2008;Andrades et al, 2009;Guo et al, 2009). A Chinese team confirmed that the difference in orbital volume between unaffected and affected sides post-operatively was not significant in the group that received individually designed titanium mesh implants, but was significant in the group that received conventional treatment.…”

Controversies in orbital reconstruction—III. Biomaterials for orbital reconstruction: a review with clinical recommendations

“…Suboptimal alignment of the implant does not necessarily lead to clinically relevant enophthalmos or diplopia. 63 Nevertheless, anatomical reconstruction of the bony orbit is an important prerequisite for predictable reconstruction. 2 Among the materials available, titanium mesh is the easiest material to shape anatomically, especially when an intraoperative skull model is used for adaptation of the implant.…”

“…65 Preformed implants may be more advantageous because of versatility and costs. 65 Andrades et al 63 concluded that pre-bent titanium implants are superior in terms of optimal reconstruction in comparison to other implants. In large defects (Jaquiéry III-VI), the implant contour becomes an increasingly important factor for repositioning the globe into a correct position.…”

“…A good implant in a bad position will lead to a suboptimal result. 63 To prevent poor implant positioning, accurate preoperative planning by mirroring a defined three-dimensional segment from the unaffected side onto the deformed/ traumatized side with computer-assisted techniques is an important aid for precise and predictable results. 81 Navigation can be beneficial, but imaging is the gold standard for peri-and postoperative evaluation of the position of the implant.…”