{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:02:58Z","timestamp":1788444178870,"version":"build-2803163510"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>There are no universally established guidelines for material selection in orbital wall fracture reconstruction. With an increasing preference for permanent implants, this study aimed to compare the long-term clinical outcomes of three different non-resorbable materials in reconstructing isolated orbital floor fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A retrospective, interventional comparative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The medical records of patients with unilateral pure orbital floor fractures who underwent orbital reconstruction using non-resorbable alloplastic implants at two tertiary referral centers between January 2017 to December 2021 were reviewed. Cases with non-pure orbital floor blowout fractures and\/or &lt;2 years of follow-up were excluded. Patients were separated into three groups according to the implant material type: porous polyethylene (PPE) sheet, polypropylene (PP) mesh, and titanium (Ti) mesh. These groups were then retrospectively analyzed for clinical outcomes, implant-related complications, and patient\u2019s satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Sixty-six patients met the inclusion criteria. Twenty-four patients (36.36%) received PPE sheets, 20 patients (30.3%) had PP mesh, and 22 patients (33.33%) received Ti mesh. At the 6-month postoperative visit, nine patients (40.9%) in the Ti mesh group experienced postoperative diplopia compared to six patients (30.0%) in the PP group and one patient (4.2%) in the PPE group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.047). Following the initial 6-month postoperative period, the PP group had more frequent postoperative enophthalmos compared to the other 2 groups. The total ocular motility restriction score was significantly lower in the Ti mesh group compared to the other 2 groups at all follow-up visits. Patient\u2019s satisfaction was significantly higher in the PPE group (median = 10, IQR = 1) compared to the PP (median = 8.5, IQR = 3) and Ti groups (median = 8, IQR = 3),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001. Reoperation was needed in seven patients (31.8%) in the Ti group, two patients (10%) in the PP group, and none in the PPE group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The use of PPE orbital implants for the repair of isolated orbital floor fracture provides better long-term clinical outcomes compared to PP or Ti mesh and reduces the need for reoperation across all fracture sizes. Ti mesh has been associated with a higher frequency of unfavorable clinical outcomes and implant removal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1100_24","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T10:00:08Z","timestamp":1737712808000},"page":"191-198","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Long-term clinical outcomes of isolated orbital floor fracture reconstruction using nonresorbable implants"],"prefix":"10.4103","volume":"73","author":[{"given":"Ayman E","family":"Abd El Ghafar","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Ophthalmic Center, Mansoura University, Mansoura, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashaat","family":"Shawky","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ophthalmic Center, Mansoura University, Mansoura, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahrous Hassan","family":"Shaheen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid Abdel","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa Mohamed","family":"Diab","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt"},{"name":"Department of Ophthalmology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"R1-20250314","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1001\/jamafacial.2016.2153","article-title":"Biomechanic factors associated with orbital floor fractures","volume":"19","author":"Patel","year":"2017","journal-title":"JAMA Facial Plast Surg"},{"key":"R2-20250314","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/S0161-6420(02)01057-6","article-title":"Clinical recommendations for repair of isolated orbital floor fractures: An evidence-based analysis","volume":"109","author":"Burnstine","year":"2002","journal-title":"Ophthalmology"},{"key":"R3-20250314","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ijom.2015.06.024","article-title":"Controversies in orbital reconstruction-III. Biomaterials for orbital reconstruction: A review with clinical recommendations","volume":"45","author":"Dubois","year":"2016","journal-title":"Int J Oral Maxillofac Surg"},{"key":"R4-20250314","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1007\/s12070-019-01724-9","article-title":"A comparative study of orbital blow out fracture repair, using autogenous bone graft and alloplastic materials","volume":"71","author":"Saha","year":"2019","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"R5-20250314","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.joms.2004.03.003","article-title":"Treatment of orbital fractures: The case for reconstruction with autogenous bone","volume":"62","author":"Kontio","year":"2004","journal-title":"J Oral Maxillofac Surg"},{"key":"R6-20250314","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/SCS.0000000000000441","article-title":"Evolving trends in the management of orbital floor 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Our experience with 34 patients","volume":"30","author":"Alkhalil","year":"2016","journal-title":"Saudi J Ophthalmol"},{"key":"R36-20250314","first-page":"4700","article-title":"Orbital floor repair using medpor porous polyethylene implants","volume":"45","author":"Lupi","year":"2004","journal-title":"Investigative Ophthalmol Vis Sci"},{"key":"R37-20250314","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1097\/01.scs.0000179744.91165.3a","article-title":"Long-term outcomes of ultra-thin porous polyethylene implants used for reconstruction of orbital floor defects","volume":"16","author":"Ozturk","year":"2005","journal-title":"J Craniofac Surg"},{"key":"R38-20250314","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s12886-016-0287-0","article-title":"Delayed onset porous polyethylene implant-related inflammation after orbital blowout fracture repair: Four case reports","volume":"16","author":"Aryasit","year":"2016","journal-title":"BMC 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