[Late reconstruction and repositioning of enophthalmos of orbital blow-out fractures].

OBJECTIVE

To investigate the surgical technique for late reconstruction and reposition of enophthalmos of orbital blow-out fractures (BOF) and its efficacy, and to evaluate the effectiveness of hydroxyapatite (HA) composite material as orbital implant material.

METHODS

Twenty-one patients with enophthalmos of BOF were randomly assigned into 2 groups in which autogenous bone and HA composite material as orbital grafting material were used. Computer orbital three-dimensional measuring technique, Hertel exophthalmometer and Lancaster test were applied. Late reconstruction of the orbit and reposition of the globe were performed on 21 cases during three months to 2 years after injury. Postoperatively, they were followed up for an average of 8 months.

RESULTS

In the 21 cases with enophthalmos of BOF, 15 patients presented moderate enophthalmos (3 - 4 mm) and 6 patients presented severe enophthalmos (5 - 6 mm). Three months after operation, the measurements demonstrated that 3 patients had no enophthalmos, 15 patients had mild enophthalmos (1 - 2 mm) and 3 patients had no effect. Sixteen of 21 patients had diplopia preoperatively. Eight patients had satisfactory result, and 8 patients had no change. There was no significant difference between orbital implants of autogenous bone and HA composite material.

CONCLUSIONS

Late reconstruction of orbit and reposition of globe for enophthalmos of BOF may obtain satisfactory results. HA composite material is a useful orbital implant material.