Repair of complex orbital fractures: technical problems, state-of-the-art solutions and future perspectives.

Within the wide range of severity of orbital fractures, the small group of complex fractures causes most of the sequelae. Therefore identification of severe injuries and adequate treatment is of major importance. The introduction of craniofacial techniques made possible a wide exposure of even large orbital wall defects and their reconstruction by grafts. In spite of significant progresses, repair of complex orbital wall defects remains a difficult surgical problem even for the experienced. This paper outlines the specific technical problems concerning surgical anatomy, exposure and defect reconstruction of this type of injuries. A number of new developments providing interesting future perspectives for orbital wall reconstruction such as intraoperative navigation, endoscopic techniques and new materials are discussed.