Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
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Orbital adherence syndrome and lower lid retraction following secondary orbital reconstruction
Author: Priti Udhay
ePoster Number: 158,00
Purpose
To analyse 15 patients with restrictive diplopia and/or lower lid retraction following secondary orbital reconstruction for complex orbital fractures . This was a retrospective study of patient records .
Methods
15 patients with either lid retraction or restrictive diplopia or both following secondary orbital reconstruction were retrospectively analysed . All patients had previous surgery done elsewhere by faciomaxillary or plastic surgeons. All the patients had complex fractures involving more than 2 walls .
Results
8 patients had hypertropia immediately after surgery which persisted beyond 6 months. All 15 patients had lower lid retraction. Lid retraction was clinically noticeable after 2 -3 weeks post operatively. All patients had inferior orbital rim plates during previous surgery . Out of 8 patients with orbital adherence 3 patients underwent replacement of titanium mesh with smooth surface implants followed by strabismus surgery. Lower lid retraction was corrected with hard palate grafts and mid face suspension.
Conclusion
The quality of titanium mesh , the surface polishing and previous orbital surgery are important contributors to causing orbital adherence. Fibrovascular ingrowth also depends upon size and density of pores within a mesh. Presence of inferior orbital rim plates maybe an important contributor to causing lid retraction . Use of smooth surface implants such as polyethylene coated titanium mesh in all patients who have had previous orbital surgery may be a good option to prevent orbital adherence. Avoidance of inferior orbital rim plates could reduce incidence of lower lid retraction .
Additional Authors
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Abstract ID: 25-600
