Orbital reconstruction: From simple materials to bioengineered solutions

Orbital fractures are a frequent and serious problem for practicing ophthalmologists. The complexity of the pathology is explained by the combined nature of the injuries (often associated with craniofacial injuries), multistage treatments, results that are often unsatisfactory, and a wide range of complaints about functional and cosmetic limitations. Over the years, significant progress has been made in the field of orbital reconstruction, allowing the transition from traditional methods using simple materials to innovative bioengineering solutions. This evolution has been driven by advances in surgical technologies, imaging techniques, and biomaterials aimed at optimizing the restoration of the shape and function of the orbital region. Traditional approaches are based on the use of autologous tissues such as bone grafts and muscle flaps, which provide biocompatibility and natural integration, but have limitations in terms of customization and accessibility. The advent of patient-specific implants and 3D printing technology has revolutionized the reconstruction of the orbit, allowing implants to be precisely adapted to a patient’s anatomy. Biocompatible materials, such as porous polyethylene, titanium, and silicone, have become the basis for orbital reconstruction, ensuring durability and compatibility while minimizing long-term complications. Bioengineered solutions hold promise for further advancements in orbital reconstruction. We searched PubMed, Cyberleninka, and other verified databases for published articles on orbital reconstruction reported in the literature between 1960 and January 2024. In this article, we consider the advantages and disadvantages of each category of reconstruction materials and provide up-to-date information on the methods for modifying their properties using modern processing technologies.