Do Orbital Implants Differ in Complication Rates: A Retrospective Study of 88 Patients, and an Argument for Cost-Effective Practices in the Face of Rising Health Care Costs

Operative repair of orbital fractures utilizes implants constructed of a plethora of materials that vary in cost. Surgeon preference as well as fracture complexity may dictate the implant chosen. In this study, we retrospectively compared the complication rates of the four most common types of implants utilized at our institution. We found no significant difference in complication rates in our sample of 88 patients. Additionally, the least expensive implant was as effective as the most expensive implant in addressing isolated orbital blowout fractures. This situation is not unique to the field of oculoplastics. As evidenced from published literature in other areas of surgery, from orthopaedics to orthodontics, cheaper alternatives often afford similar outcomes as more expensive options. We herein argue that a cost-effective approach should be considered while still allowing for high quality of care, in the face of rising health care costs and health disparities in America.

Two Cases of Orbital Blowout Fractures with Extraocular Muscle Entrapment in Children

Orbital blowout fracture is a common result of facial trauma and with the expanded use of endoscopy in orbital blowout fracture surgery, otolaryngologists are participating more often blowout fracture surgery. Because orbital blowout fracture may result in sequelae such as diplopia and enophthalmos, proper diagnosis and timing of repair are crucial. Orbital blowout fracture with extraocular muscle entrapment is uncommon and almost exclusively seen in children. It needs emergent release of entrapped muscle to prevent permanent sequelae (e.g., diplopia). The authors experienced two cases of orbital blowout fracture with extraocular muscle entrapment and had good surgical results without any sequelae. We report these cases with a review of the literature.