Functional Recovery After Late Orbital Floor Reconstruction Using Autologous Grafts

Delayed orbital floor reconstruction is generally considered less effective due to fibrosis, scarring, and chronic soft-tissue changes. Most published late repair techniques rely on patient-specific implants (PSIs) to restore orbital volume and anatomy. However, the effectiveness of delayed reconstruction using autologous grafts remains less explored. We present 2 patients who underwent late orbital floor repair several months after trauma-one after multiple failed surgeries-with functional outcomes achieved using autologous cartilage and iliac crest bone grafts rather than PSIs. Both patients demonstrated marked postoperative improvement, including resolution or significant regression of diplopia, improved extraocular motility, and restoration of orbital support. These cases highlight that carefully selected patients may benefit from delayed reconstruction not only using PSIs but also autologous grafts, even in the chronic phase of injury.