Clinical Application Of Titanium Mesh Combined With Medpor For The Orbital Fracture

Objective:Explore the safety and efficacy of the titanium mesh combined with porous high density polyethylene(Medpor) to repair the orbital fracture.Methods:Collected during October 2013 to September 2014 in the first affiliated hospital of nanchang university ophthalmology surgical treatment of 18 patients with orbital fracture.18 patients have different degree of enophthalmos, 12 cases exist diplopia, 11 cases of eye movement disorders.All patients who are using titanium mesh combined with porous high density polyethylene(Medpor) as implant materials.Postoperative through orbital CT to determine fracture repair, compare the preoperative,postoperative 1 week, 1 month, 3 months, 6 months of enophthalmos, diplopia, eye movement disorder and so on.Result:1.Postoperative follow-up 6~12 months. All patients with postoperative orbital CT showed the orbital wall anatomy basic reset.2.Enophthalmos aspects: all the 18 cases of patients with preoperative exist different degrees of enophthalmos.After 6 months, 17 cases(94.4%) eyes projection difference is less than 2 mm, only 1 case(5.6%), although the preoperative has improved, but there are still a mild enophthalmos.The degree of enophthalmos of the six months compared with postoperative, the difference was statistically significant(P>0.05).3.Diplopia: 12 of the 18 patients with preoperative patients with preoperative exist different degrees of diplopia, 10 cases(55.5%) having level I diplopia, 2 cases(11.1%) having level II diplopia, 6 cases(33.3%) without diplopia.After 6 months,only 1 case(5.6%) having level I diplopia,and the rest of the 17 cases(94.4%) had no diplopia.The diplopia of the six months compared with postoperative, the difference was statistically Significant(P>0.05).4.Eye movement: 11 of 18 patients with preoperative patients with preoperativeexist different degrees of eye movement disorder, 9 cases(50.0%) having level I eye movement disorder, 2 cases(11.1%) having level II eye movement disorder, 7 cases(38.9%) having no eye movement disorder.After six months,only 1 case(5.6%) having level I eye movement disorder, and the rest of the 17 cases(94.4%) having no eye movement disorders. The eye movement of the six months compared with postoperative, the difference was statistically significant(P>0.05).5.All the patients had no vision loss and no implants infection, rejection, shift.Conclusion:In orbital fracture reconstructive surgery, the use of titanium mesh combined with porous high density polyethylene(Medpor) as implant material can effectively restore the anatomic structure of orbital wall, correcting enophthalmos, improving diplopia and eye movement,curative effect and less complications.