Role of Patient Specific Implant in Reconstruction of Post Traumatic Orbital Defects: A Comparative Systematic Review

Abstract

Background: Maxillofacial injuries of middle third of the face commonly involves the orbital skeleton and range from the subtle blow-out fracture following simple blunt or low-velocity trauma to the highly complex orbital communication resulting from motor vehicle accidents and projectiles, such trauma to the orbit and surrounding facial structures often leads to orbital deformity and incapacitating visual dysfunction We performed a systematic review to evaluate the role of patient-specific implants in orbital reconstruction and to compare it with conventional reconstruction methods with respect to operative time, orbital volume reconstitution, enophthalmos and diplopia.

Material and Methods: A literature search was conducted using the English-language databases EMBASE, MEDLINE, PUBMED and the COCHRANE LIBRARY, as well as local databases containing publications from 2006 to 2022.

Results: fourteen studies (n=737 patients) met the inclusion criteria. Overall, the use of patient specific implants for the orbital repair when comparing with conventional in terms of intra operative duration, post-operative orbital volume difference and enopthalmos, however in terms of presence of post- operative diplopia there is no significant difference in either.

Conclusion: Patient specific implants are easy to manipulate, insert and anchor. They accurately reproduce orbital contours thus restoring orbital volume. This leads to reduced operative time and an improvement in functional and aesthetic outcomes of post-traumatic orbital reconstruction.