Evaluation of the effect of Medpor implantation on extraocular muscle function, eye movement disturbance and diplopia in patients with orbital wall fracture

Objective: To evaluate the impact of Medpor implantation on extraocular muscle function, eye movement disorders, and diplopia in patients with orbital wall fracture. Methods: A retrospective study was conducted on 98 patients (98 eyes) who underwent Medpor implantation surgery at Bethune International Peace Hospital from January 2019 to December 2022. The degree of eyeball enophthalmos and total fracture area in patients before and after surgery, as well as orbital volume were measured. The relationship between enophthalmos severity and total fracture area was analyzed. Changes in extraocular muscle function, eye movement, and diplopia were assessed before and after surgery. Results: Before operation, enophthalmos severity was correlated with the total fracture area (r = 0.323, P = 0.001). After surgery, there was no significant correlation (r = -0.053, P = 0.630). Compared with preoperative measurements, both orbital volume and the volume difference improved significantly after surgery (both P < 0.05). Among the patients who received surgery within 3 weeks, the cure rates for rectus muscle restriction and extraocular muscle paralysis were 94.12% and 100.00%, respectively, higher than those in patients who underwent surgery after 3 weeks (67.27% and 65.62%) (P < 0.05). In comparison of preoperative conditions, notable improvements were observed in both ocular motility disorders and diplopia after operation (both P < 0.05). The total improvement rates in ocular motility disorders at 1, 3 and 6 months of follow-up were 84.69%, 90.82%, 96.94%, respectively, while these rates in diplopia were 89.79%, 91.84% and 95.92%, respectively. Abnormal maxillofacial sensations also improved significantly at 1-, 3-, and 6-month post-surgery (all P < 0.05). Conclusions: Medpor implantation effectively restores extraocular muscle function in patients with orbital wall fractures, significantly alleviating diplopia, eye movement disorders, and maxillofacial abnormalities.