This is a review from Chile of five patients who underwent surgery utilising customised implants. Two methods to make the titanium implants were used between the five patients. All patients had diplopia in the gaze position prior to implant placement. None had diplopia postoperatively in the first 20 degrees of field of vision. The success of enophthalmos correction was evaluated subjectively with CT evaluation of the orbital volume. They found that the volume of the orbits reconstructed with the customised implants was on average 6.3% less compared to the volume of the unaffected side. The best result was obtained in the patient with an overcorrection of 12.3%. The article has a number of flaws, not least different methods of constructing the implants and the small number of patients. The severe diplopia would also be a concern. Nonetheless it does highlight mirror imaging of the contra-lateral orbit and raising the issue of orbital volume over correction. The aim would be to limit the number of operations to correct the difficult post traumatic enophthalmos and this method at least may have some predictability.

Can customise implants correct enophthalmos and delay diplopia in post-traumatic orbital deformities? Pedemonte C, Saez F, Vargas I, et al.
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Stuart Clark

Manchester Royal Infirmary, Manchester, UK.

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