Orbital fractures are increasingly complex; some of these fractures may need more than one surgery to fully correct the defects. Many treatments are described to orbital surgery, according to one systemic review almost 19 different types of materials were used, the most frequent: autologous materials, alloplastic materials, anatomical mesh and customized titanium mesh, in our experience with any of this materials although excellent results in low and moderate wall defects may be accomplished, in late severe orbital defects are not sufficient to accomplish necessary support and projection of the eye ball, resulting in aesthetics and functional problems. Progress made in Computer Tomography (CT) gave us a more accurate stereolithography so we can elaborate an individual and unique titanium implant.

Patients and materials : A series of patients treated in our service, all of them suffer from a high energy impact, diagnosed with panfacial fracture involving severe compromise of the orbital cavity. They were treated in different surgical phases according to their injuries; in every case enophtalmo and/or diplopia were found after the early phases of treatment. Customized titanium implants were surgically implanted in the damaged orbit.

Results : After late surgery all patients improve in aesthetics and function.