Outcomes of Posttraumatic Orbital Reconstruction: The Role of Virtual Surgical Planning and Differential Volumetric Orbital Restoration

Background: Orbital fractures present complex reconstructive challenges due to intricate anatomy, functional demands, and aesthetic considerations. Objective: This study evaluates the functional and aesthetic outcomes of posttraumatic orbital reconstruction, with emphasis on early intervention, virtual surgical planning (VSP), and the novel Differential Volumetric Orbital Restoration (DVOR) technique. Patients and Methods: A prospective study of 20 patients, one was excluded by inability for follow up and the others (19 patients) undergoing orbital reconstruction was conducted over one year. Data included demographics, mechanism of injury, fracture pattern, timing of surgery, materials used, surgical approach, and use of VSP. Outcomes assessed were enophthalmos, diplopia, infraorbital hypoesthesia, ocular motility, complications, and patient satisfaction. Results: Mean age was 18.8 ± 9.76 years; 68.42% were male. Road traffic accidents accounted for 78.95% of injuries. VSP was used in 42.11% of cases; titanium mesh was used in 78.95%. Postoperative improvements were significant for enophthalmos (68.42% to 5.26%) diplopia (68.42% to 5.26%), and infraorbital hypoesthesia (100% to 26.32%) (P<0.001). Complications included ectropion (10.53%) visible scars (15.79%), and nasolacrimal duct obstruction (10.53%)—one treated conservatively, one with stenting. No infections or dystopia occurred. Satisfaction was reported in 78.95% of patients. Conclusions: Early orbital reconstruction using VSP and DVOR achieves precise restoration of orbital volume and globe position with low complication rates.