Is there any option for me after two orbital floor fracture surgeries?

I had my orbital floor fractured in Jan this year. After first surgery there was considerable enophthalmos so I went for second. In second surgery my surgeon put a 4mm thick Medpor implant in my orbit. However, after 5 months of surgery now I have exophthalmos probably due to thicker implant and lower lid retraction. I also have double vision in only Up and Down gazes.Should I go for third surgery for correction of exophthalmos?Will it be possible to remove this implant after more than one year?

Doctor Answers 5

Fracture Revision

First and foremost, I would suggest re-imaging to evaluate the position of the implant(s) and the eye muscles. Is the double vision new since the most recent surgery, or has it been present all along? You can certainly have surgery to remove the implant at any time - as more time passes, it becomes harder to do particularly with MedPor because scar tissue grows into the implant, but it can still certainly be removed. I would suggest seeing an orbital surgeon with extensive experience in fracture repair and revision.

New Haven Oculoplastic Surgeon

Orbital floor fracture

Hi chetan.sharma_99,
Thanks for your question and I'm sorry to hear that you've been struggling since your orbital fracture. If you continue to have double vision at 5-6 months after surgery, I would consider additional imaging (CT scan) to re-evaluate your orbit and the hardware that was placed. Depending on the amount of exophthalmos, a third surgery should be considered if there is significant cosmetic asymmetry or any issues with exposure of your cornea. Even after a year, augmentation of a Medpor implant should still be possible. Additional surgery on the eye muscles may also be required to fix your double vision. 
I would recommend you seek an evaluation with a skilled oculoplastic surgeon in your area. 
Good luck!

John McCann, MD, PhD
Sandy Oculoplastic Surgeon
4.8 out of 5 stars 4 reviews

Double Vision And Lid Retraction After Orbital Fracture Surgeries

I am sorry to hear that you have had so much difficulty healing after sustaining such a significant trauma.  If you are having such issues with persistent double vision in straight or down gaze and lower lid retraction, then you should certainly seek consultation with an Oculoplastic surgeon.  There are surgical options available to appropriately treat both of these issues, but you would require a full examination to determine what will be best for your specific case.  Best, Dr. Gregory Lewen

Gregory D. Lewen, MD, FACS
Miami Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

Reconstruction after orbital fracture

I would definitely call an oculoplastic surgeon with expertise in orbital and volume augmentation esepcially with your symptoms of double vision and multiple surgeries. There are options to fix both the volume and double vision issues that can be addressed surgically and non surgically.

Sean Paul, MD
Austin Oculoplastic Surgeon
5.0 out of 5 stars 18 reviews

Orbital floor fracture

I am sorry you are having so much trouble. I would recommend you goto a oculoplastic surgeon who is comfortable with complex orbital trauma.  It is possible to fix the exophthalmos and remove the implant. Good luck.

Lisa M. DiFrancesco, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 34 reviews

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