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S.L. Merbs, N.T. Iliff, M.P. Grant, D.C. Garibaldi; Use of MEDPOR TITAN Implants in Orbital Reconstruction . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4210.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Both MEDPOR polyethylene and titanium mesh have been successfully used for orbital reconstruction. Titanium mesh has the advantage of a high tensile strength, memory after shaping, and radio–opacity allowing it to be seen on post–operative CT scans. However, titanium implants can be difficult to insert because of sharp points after shaping and orbital tissues, including extraocular muscles, can adhere to the mesh. BARRIER MEDPOR polyethylene implants have a smooth surface to face orbital tissues, preventing adherence and a porous surface to allow tissue ingrowth. However, MEDPOR implants have less tensile strength, are not as easy to shape, and are not seen on post–operative scans. We have examined the effectiveness of a new orbital implant, which combines the benefits of both MEDPOR polyethylene and titanium mesh, in the reconstruction of orbital defects. Methods: In a retrospective, non–comparative case series, we evaluated 12 consecutive patients who had placement of at least one MEDPOR TITAN plate during orbital reconstruction performed by the authors since October 2004. Surgeons were questioned as to the advantages and disadvantages of the novel implant. Patient charts and pre–operative and post–operative scans were reviewed for any complications associated with the implants. Results: 10 males and 2 females underwent placement of a MEDPOR TITAN implant. Patient ages ranged from 3 to 73. 10 patients had acute fracture repair (7 floor fractures, 2 medial wall fractures, and 1 floor and medial wall fracture) an average of 7 days after injury; 1 patient had late enophthalmos repair; and 1 patient had orbital reconstruction after tumor removal. Both MTB (MEDPOR TITAN BARRIER) and BTB (MEDPOR TITAN Double BARRIER) implants were used and were typically fixated with 1 or 2 microscrews. Surgeons reported that the implants were easy to shape, had sufficient tensile strength to maintain their contour, and were well–visualized on post–operative CT scans. No short–term complications were noted, and patients continue to be followed for evidence of long term complications. Conclusions: Although many materials have been used in orbital reconstruction, no implant has all the desirable characteristics. The new MEDPOR TITAN implants represent a new alternative that has several advantages over other currently available implants.
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