Wahid Abdullah, Salem Wajih
(2008)
A comparative study on the outcomes of orbital floor
reconstruction with autogenous grafts versus porous
polyethylene (medpor) in Hospital Unversiti sains
Malaysia from 2004-2007.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
To determine the difference in surgical outcomes of orbital floor reconstruction
between the use of two different reconstructive materials.
Method: All patients who underwent orbital floor reconstruction in the study period were
divided into two groups according to the materials used for the grafts. All patients
underwent comprehensive ocular examinations, Goldmann perimetery, Hess chart test and
ex ophthalmometry.
Results: Thirty-five patients underwent orbital floor reconstruction within the study period
in our center. Twenty-six patients were analyzed. Autogenous grafts were used in 14
patients (53 %), and medpor in 12 patients (46.2%). Among our patients, 84.6% of them
were males and 15.6 % females. The mean age was 24.5(8.2) years. Motor vehicle
accidents were attributed to 96.2%. Motorcyclists were the most common victims (76.9%).
The most common clinical presentations were diplopia 61.6% and enophthalmos 50%. In
our study 50% of orbital floor reconstructions were carried out within 2 weeks and 73. I %
of the cases were approached through blepharoplasty incision. Postoperatively there was no
diplopia in primary gaze. In all cases however diplopia in the inferior and peripheral gaze was found 11.5% and 26.9% respectively in autogenous group, and 3.8% and 26.9% in
medpor group (P = 1.24).
Enophthalmos was 11.4 % in autogenous graft group and 15.3 % in medpor group (P=
0.465). Hess chart was found to be abnormal in 11.4 % for each group (P = 0.062).
Restricted extraocular movements were seen in one (3.8 %) patient of autogenous group
and 7.7% of patients in medpor group (P = 0.574).
Conclusion: The outcome of orbital floor reconstruction by medpor was comparable and as
good as autogenous graft, and there was no statistically significant difference between the
two groups. Goldmann perimetry was a more objective binocular visual field test to detect
diplopia and extraocular deficits.
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