Orbital surgery for trauma, benign or malignant tumors almost always involves the restoration of the orbital skeleton. A myriad of materials have been used for this purpose. Complex orbital reconstruction invariably requires the use of bone grafts. Autologous cal-varial bone grafts are biologically the most compatible for this purpose with excellent long term results. Graft requirements are determined by proper classification of defects. A surgical reconstruction algorithm has been developed from a series of 18 patients requiring bone grafts for orbital reconstruction from a total of 111 orbital surgeries. The indications, techniques and potential problems are analyzed.
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