Correspondence: Dr Hamilton, Osborne Head and Neck Institute, Cedars Sinai Medical Towers, 8631 W Third St, Ste 945E, Los Angeles, CA 90048 (firstname.lastname@example.org).
I appreciate the comments made by Williams and Parmar. I would like to specifically address each of their suggested limitations to our study. First, Williams and Parmar argue that SupraFoil is not an appropriate material for orbital floor repair because it lacks the ability to retain a molded shape like titanium mesh implants. I disagree with this statement. The “ability [of an implant] to retain its molded shape” is not a criterion for successful restoration of the orbital floor after fracture. The goals of surgery are the elevation of herniated or entrapped orbital soft tissues and the placement of an interposition graft between those soft tissues and the bony defect to allow the floor time to heal. An implant needs to support the orbital contents only during this healing phase. After the orbital floor is healed, the implant is simply a foreign body and is not required to maintain the position of the globe. Studies1-2 using absorbable implants to successfully reconstruct orbital floor fractures support this theory. SupraFoil is specifically designed for orbital floor repair. It is flexible yet rigid enough to support the orbital contents during the critical healing phase. The superiority of molded rigid implants vs semirigid implants such as MEDPOR TITAN, Silastic, or nylon sheeting is not supported in the literature.
Hamilton JS. Orbital Floor Fracture Repair—Reply. Arch Facial Plast Surg. 2007;9(4):301. doi:10.1001/archfaci.9.4.301