INTRODUCTION: Long-term enophthalmos and diplopia resulting from orbital bone loss pose significant challenges in reconstructive surgery. This study evaluated the effectiveness of patient-specific porous titanium implants (PSIs) for addressing these conditions. MATERIALS AND METHODS: This retrospective study involved 12 patients treated at Croix-Rousse Hospital, Lyon, from April 2015 to April 2022 who underwent late reconstruction via PSI for unilateral complex orbital bone loss. These implants were customized via 3D mirroring techniques on the basis of high-resolution computed tomography (CT) scans of the patients' unaffected orbits. RESULTS: All 12 patients presented with significant preoperative enophthalmos, with an average displacement of 3.24 mm, which was effectively corrected postoperatively to an average of 0.17 mm (p <
0.001). Orbital volume notably improved from a preoperative average of 3.38 mL to 0.37 mL postsurgery (p <
0.001). Functional improvements were evident as both enophthalmos and diplopia resolved completely. The Lancaster test revealed an improvement in the visual field, with 83.3 % of patients achieving normal results postoperatively. DISCUSSION: By ensuring anatomical accuracy, patient-specific porous titanium implants, tailored from patient-specific imaging and fabricated via advanced 3D printing technology, provide a precise, effective, and reliable solution for reconstructing complex orbital defects and performing complicated revision surgeries.