Use of lorenz titanium implants in orbital fracture repair

PURPOSE: To present the experience and outcomes of orbital fracture repair using Lorenz titanium orbital implants in one tertiary care center. METHODS: Five-year retrospective chart review of 55 patients who underwent orbital fracture repair with Lorenz titanium orbital implants since 2002. The following data were recorded: age; gender; mechanism of injury; prior fracture repair; concomitant ocular injuries; time elapsed between injury and surgery; and preoperative and postoperative visual acuity, diplopia, extraocular motility, and Hertel exophthalmometry. All patients underwent preoperative CT. Operative data included surgical approach, type of Lorenz implant used, duration of surgery, and presence of extraocular muscle entrapment. Length of follow-up and complications were also recorded. RESULTS: Of those undergoing primary repair, diplopia in primary gaze was present in 29.3% of patients preoperatively and 0% postoperatively. Severe, moderate, and mild motility restriction in any gaze direction were 5.5%, 14.5%, and 34.5% preoperatively and decreased to 0%, 1.8%, and 7.3% postoperatively. Although only 14.3% of primary repair patients had full extraocular motility prior to surgery, this number increased to 80% after surgical repair. More than 80% of patients achieved symmetry within 1 mm by Hertel exophthalmometry. The authors did not encounter instances of implant extrusion, infection, or eyelid malposition during follow-up. CONCLUSIONS: Orbital fracture repair using Lorenz titanium orbital implants provides reliable and reproducible stabilization of orbital wall defects, while offering outstanding functional and cosmetic results comparable with other alloplastic materials.