Introduction: Orbital fractures are common facial injuries. The zygomatic–orbital complex is a common anatomical structure affected, although it could be as a pure blow-out fracture or as part of a panfacial injuries.

Objective: To report four cases using different biomaterials as a surgical reconstruction in patients with a blow out fracture in the inferior orbital wall.

Background: The literature of the past 20 years is replete with reports of the diagnosis of treatment of the blow out fractures. Ocular symptoms are commonly persisted after surgery. Some fractures require just observations other required surgical reduction. The goal of surgery intended to reposition the herniated orbital fat tissue back into the orbit and to reconstruct the traumatic defect.

Patients, Materials and methods: Four patients underwent surgical procedure for an orbital floor fracture presenting a blow out fracture at The Metropolitan Hospital. Three cases were treated with miniplates and screws (M–S), and the other case with wire and polyethylene mesh. Alternative meshes were used for the 2 M–S; M–S with titanium mesh, M–S with polyethylene mesh and the last case just with M–S.

Results: The patients did not present any complications, although 2 patients manifested diplopia after the surgery. We had no evidence of biomaterial extrusion.

Conclusion: We have not found significant difference between biomaterials types in reconstructive orbital floor. The most common post-surgical complications are: diplopia, herniation of the orbital fat, disturbance of ocular motility. We find best results in patient who had early surgical treatment.

Conflict of interest : None declared.