Supporting implant technique for repairing large medial orbital wall fractures

Purpose: To introduce a new surgical technique for repairing large medial wall fractures stably with insufficient bony structures. Methods: This is a case series of 29 patients who underwent surgery for repairing large medial wall fractures using the new supporting implant technique in Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. Medical records and radiologic images of the patients were reviewed retrospectively. The outcomes evaluated were the incidence and the degree of diplopia and enophthalmos, and orbital volume restoration after surgery. The institutional review board approved this study, and the study adhered to the tenets of the Declaration of Helsinki. Results: Orbital reconstruction using the supporting implant technique was performed without any complications. The incidence of diplopia was 51.7% including 6.9% of significant diplopia before and 27.6% with no significant diplopia 3 months after surgery (p = 0.022). The average enophthalmos was successfully corrected from 0.93 mm preoperatively to 0.36 mm at 3 months postoperatively (p = 0.001). Orbital volume was corrected from 25.71 to 23.59 cm³ after surgery, which was not significantly different from the contralateral unaffected orbit (p = 0.157). Conclusions: The supporting implant technique is a simple and effective surgical method that provides sufficient support and prevents implant migration in large medial orbital wall fractures.