Reconstrucción óculo-orbitaria en traumatismo severo: revisión sistemática del abordaje diagnóstico y quirúrgico desde urgencias, oftalmología y cirugía plástica
Keywords:
Severe oculo-orbital trauma; Oculo-orbital reconstruction; Surgical management in facial trauma; Complex orbital fractures; Patient-specific implants; Facial reconstructive plastic surgery; Ophthalmic surgery; BETT; Post-traumatic functional and aesthetic evaluation; Orbital surgical complications; Comprehensive postoperative assessment; Specialized intervention in polytrauma settings.Abstract
Severe oculo-orbital trauma is a highly complex medical condition that compromises the anatomical and functional integrity of the globe and its adjacent structures, carrying a high risk of visual, aesthetic, and life-threatening sequelae. In the absence of standardized protocols, this systematic review aimed to identify and synthesize the most recent evidence on diagnostic and reconstructive strategies applied in emergency, ophthalmology, and plastic surgery settings. A structured search was conducted across nine scientific databases, including studies published between January 2020 and March 2025. A total of 228 articles were excluded due to publication date and 59 for not meeting thematic or methodological criteria. Ultimately, 37 studies were included in the qualitative synthesis. Findings indicate that specialized reconstruction using virtual planning, surgical navigation, and patient-specific implants significantly improves functional and aesthetic outcomes, with lower complication rates and reduced need for reintervention. Early intervention and multidisciplinary coordination from the emergency setting are key determinants of prognosis. The need to establish evidence-based clinical guidelines to standardize the surgical management of severe oculo-orbital trauma is emphasized.
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