Abstract
Purpose: Although nylon foil is a well-established material for orbital floor reconstruction, no standardized template has been described to guide implant sizing. We describe a reproducible nylon foil template for repair of isolated orbital floor fractures and evaluate clinical outcomes in a consecutive series of 35 patients.
Methods: A retrospective consecutive case series was performed of patients undergoing repair of isolated orbital floor fractures with nylon foil implants between 2011 and 2024. A single surgeon used the same standardized ovoid nylon foil template for every case, regardless of fracture size. Demographic, clinical, radiographic, operative and postoperative outcome data were reviewed. Patients were followed for a minimum of 90 days and postoperative complications were recorded.
Results: Of 255 patients, 35 met inclusion criteria. The average patient age was 47.6 ± 19.6 years (range 21-80), with 16 males (45.7%) and 19 females (54.3%). Average time from injury to surgery was 11.7 ± 3.6 days (range 6-18) and average follow-up duration was 186.0 ± 90.5 days (range 90-371). Fracture sizes were classified by transverse length on CT scans as follows: 5 (14.3%) small (0-6 mm), 11 (31.4%) medium (7-13 mm) and 19 (54.3%) large (14-20 mm). No cases of implant migration, extrusion, abscess, fistula or mucocele occurred during the short follow up period. There was statistically significant improvement of diplopia and extraocular motility deficits in the study group.
Conclusions: A standardized nylon foil template provides reliable repair of isolated orbital floor fractures of all sizes with low complication rates and no implant migration or extrusion. Standardizing implant size may simplify orbital reconstruction, improve surgical reproducibility and reduce the learning curve for individualized intraoperative implant customization.