The lenses should be made of polycarbonate, and the frames should be larger than the orbital entrance. Most complications are the result of either malpositioning the implant or using the wrong size implant. Occasionally, trauma to the inferior rectus occurs during the attempt to release it from the fracture site. Palsy may result. This usually resolves spontaneously but may take as many as 3 months to resolve.
Most cases do well, and most patients obtain resolution of diplopia and correction of enophthalmos.
Warn patients to avoid strenuous activity and to use common sense when determining their postoperative activity level. In addition, warn them to avoid nose blowing for several weeks after the injury and repair. Educate patients about nerve damage recovery. In some cases, the damage may be permanent. A complete ophthalmic evaluation preoperatively is essential and is the standard of care.