[Late reconstruction and repositioning of enophthalmos of orbital blow-out fractures].

OBJECTIVE: To investigate the surgical technique for late reconstruction and reposition of enophthalmos of orbital blow-out fractures (BOF) and its efficacy, and to evaluate the effectiveness of hydroxyapatite (HA) composite material as orbital implant material.

METHODS: Twenty-one patients with enophthalmos of BOF were randomly assigned into 2 groups in which autogenous bone and HA composite material as orbital grafting material were used. Computer orbital three-dimensional measuring technique, Hertel exophthalmometer and Lancaster test were applied. Late reconstruction of the orbit and reposition of the globe were performed on 21 cases during three months to 2 years after injury. Postoperatively, they were followed up for an average of 8 months.

RESULTS: In the 21 cases with enophthalmos of BOF, 15 patients presented moderate enophthalmos (3 - 4 mm) and 6 patients presented severe enophthalmos (5 - 6 mm). Three months after operation, the measurements demonstrated that 3 patients had no enophthalmos, 15 patients had mild enophthalmos (1 - 2 mm) and 3 patients had no effect. Sixteen of 21 patients had diplopia preoperatively. Eight patients had satisfactory result, and 8 patients had no change. There was no significant difference between orbital implants of autogenous bone and HA composite material.

CONCLUSIONS: Late reconstruction of orbit and reposition of globe for enophthalmos of BOF may obtain satisfactory results. HA composite material is a useful orbital implant material.