Correction of Delayed Traumatic Enophthalmos Using Customized Orbital Implants

Publication date: Available online 21 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Christian Pedemonte Trewhela, Marlene Díaz Reiher, Tamara Muñoz Zavala, L. Edgardo González Mora, Ilich Vargas Farren
PurposeTo determine the relationship between the overcorrection of orbital volume and ocular projection in patients who have suffered orbital trauma.MethodsA prospective cohort study was performed on patients with enophthalmos as a side effect of orbital trauma. The sample included patients over 18 years of age who required reconstruction using customized implants to treat enophthalmos and/or diplopia. The exclusion criteria were patients who suffered multiple or extended fractures, patients with amaurosis and/or prosthetic eye. Orbital volumes were calculated and the position of the eyeball in the healthy and traumatized sockets were determined prior to and after installing the implant and the ratio between these variables was calculated. Two variables were identified: (1) orbital volume, (2) enophthalmos. An analysis of the estimator variables was performed, defining three groups: (1) "healthy eye socket", (2) "traumatized eye socket without implant," (3) "traumatized eye socket with implant". A Shapiro-Wilk test, paired t and linear regression analysis were performed. P Value < 0.05 (confidence interval 95%) indicated significant differencesResultsFrom 294 patients who underwent orbital-zygomatic complex reconstruction surgery, 13 required customized implants and only 5 met the inclusion criteria. The average volumetric variation in the group of traumatized eye sockets with and without implants was statistically significant (p < 0.05), overcorrecting by an average of 4.2cm³. The average enophthalmos variation in the group of traumatized eye sockets with and without implants was statistically significant (p < 0.05), projecting the eyeball by an average 1.80 mm. The ratio between the average orbital volume and projection of the eyeball was determined to be 1:0.721, with a correlation of 45.6%.ConclusionThis study concluded that the eyeball is projected 0.7 mm for every 1 cm³ of volume added in customized orbital implants. However, it is fundamental that additional clinical studies with larger samples be conducted.



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