Revisiting the Role of the Channel Implant in Late and Revision Orbital Fractures.

Authors

Hatem A Tawfik, Farah Elwakil, Omar Amro El Houssieny

Published in

Ophthalmic plastic and reconstructive surgery. Jul 24, 2026. Epub Jul 24, 2026.

Abstract

To revisit the role of the porous polyethylene channel implant (PPCI) in consecutive patients with late or revision orbital floor fractures.
A retrospective, institutional review board-approved chart review was performed, encompassing all consecutive patients who underwent PPCI implantation over an 18-year period (2007-2025). Demographic data and clinical examination findings were systematically documented. Selected cases included patients with: (1) late (≥1 year) orbital fractures and (2) revision orbital fractures with complicated hardware. Anophthalmic patients with late (neglected) orbital fractures or with extensive bony loss were not excluded.
Sixteen orbits in 15 patients (12 males, 3 females; mean age, 30 years) met the inclusion criteria. Eleven late fractures (68.75%) underwent primary repair with PPCI, while 5 orbits (31.25%) underwent revision surgery following complicated titanium or patient-specific implants. The mean interval between trauma and PPCI placement was 15.2 months, and this interval was significantly shorter in revision fractures (6.2 months) compared with late fractures (17.4 months, p < 0.0001). Overall, all patients experienced improvement in enophthalmos and hypoglobus, despite incomplete availability of quantitative measurements across the cohort. Four PPCI designs were used, with follow-up averaging 23.3 months. Enophthalmos improved from 3.875 mm to 1.5 mm, and diplopia resolved in 62.5% of patients. Intraoperative complications included linear fissure fractures of the PPCI (n = 2), which occurred during attempts to contour the device to accommodate a combined orbital floor and medial wall defect, and fracture (fishmouthing) of the PPCI channel entry (n = 3). Postoperative complications included palpable screws (n = 2), permanent hyperglobus (n = 1), and recurrent enophthalmos (n = 1).
In selected patients, the PPCI provides a simple all-in-one solution with adequate volume restoration and relatively few complications.

PMID:
42497100
Bibliographic data and abstract were imported from PubMed on 25 Jul 2026.

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