Anatomical 3-dimensional pre-bent titanium implant for orbital floor fractures

Purpose: This cadaver study evaluates the use of pre-bent 3-dimensional titanium mesh implants for orbital floor and medial wall reconstruction. Design: Nonrandomized comparative study. Participants: Eight human cadaveric heads (n = 16 orbits). Methods: Transcutaneous incisions were used to expose both orbital floors in each cadaveric head. Unilateral orbital floor and medial wall fractures were generated in each specimen. The contralateral orbit remained uninjured. The fractures then were repaired with pre-bent titanium mesh fan plates molded from aluminum templates presenting different sizes. The templates were generated from topographical computed tomography (CT) data previously obtained from normal subjects. The accuracy of orbital reconstruction was evaluated with postoperative CT scans. Main Outcome Measures: The mean value of the distances between the implant and the bony orbit was evaluated. Results: The mean distance between all 16 plates and their respective orbital floors/medial walls was 0.81 +/- 0.74 mm. Mean values were 0.68 +/- 0.63 mm for the unfractured side and 0.93 +/- 0.82 mm for the fractured side. No significant differences were found between orbits when evaluated for side of injury, gender, or size of defect. Conclusion: Pre-bent 3-dimensional titanium mesh implants provide accurate reconstruction of orbital floor and medial orbital wall fractures. The mean implant error was < 1 mm for all orbits studied. (c) 2006 by the American Academy of Ophthalmology.