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Hydroxyapatite Orbital Implant After Enucleation Experience With Initial 100 Consecutive Cases

Hydroxyapatite Orbital Implant After Enucleation Experience With Initial 100 Consecutive Cases Abstract • The hydroxyapatite orbital implant is designed to provide the enucleated patient with improved motility of the prosthesis. We report the results of our first 100 consecutive cases of hydroxyapatite implantation in eyes enucleated primarily for intraocular neoplasms. During a median of 11 months' follow-up, there have been no cases of orbital infection, implant extrusion, or implant migration. Minor postoperative problems have included transient orbital pain in six patients, Tenon's fascia edema and buried peg from tissue overgrowth in two patients each, wound erosion and peg extrusion in one patient each, and audible click of the peg in three patients. Movement of the socket and fornices was excellent in 99% of patients. Motility was cosmetically satisfactory with 10° to 15° rapid darting prosthesis movement present in 96% of patients regardless of whether the peg had been placed. Large-degree prosthesis motility (>15°) was present in 24% of all patients and was most impressive in those adults who had the peg in place and in children. The hydroxyapatite implant appears to be well tolerated and provides prosthesis motility with few problems. References 1. Shields JA, Shields CL. Intraocular Tumors: A Text and Atlas . Philadelphia, Pa: WB Saunders Co; 1991:37-41. 2. Soll DB. The anophthalmic socket . Ophthalmology . 1982;89:407-423.Crossref 3. Gougelmann HP. The evolution of the ocular motility implant . In: Shannon GM, Connelly FJ, eds. Oculoplastic Surgery and Prosthetics . Boston, Mass: Little Brown & Co Inc; 1970:689-711. 4. Kennedy RE. Enucleation, evisceration, and exenteration . In: Iliff NT, ed. Complications in Ophthalmic Surgery . New York, NY: Churchill Livingstone Inc; 1983:487-513. 5. Perry AC. Advances in enucleation . Ophthal Plast Reconstr Surg . 1991;4:173-177. 6. Perry AC. Integrated orbital implants . In: Bosniak SM, Smith BC, eds. Advances in Ophthalmic Plastic and Reconstructive Surgery . Elmsford, NY: Pergamon Press Inc; 1990:75-81. 7. Wolter JR. Tenonectomy: treatment of epibulbar extension of choroidal melanomas . Arch Ophthalmol . 1971;86:529-533.Crossref 8. Nerad JA, Hurtig RR, Carter KD, Bulgarelli DM, Yeager DC. A system for measurement of prosthetic eye movements using a magnetic search coil technique . Ophthal Plast Reconstr Surg . 1991;7:31-40.Crossref 9. Dutton JJ. Corallin hydroxyapatite as an ocular implant . Ophthalmology . 1991;98:370-377.Crossref 10. Benevento WJ, Murray P, Reed CA, Pepose JS. The sensitivity of Neisseria gonorrhoeae, Chlamydia trachomatis, and herpes simplex type II to disinfection with povidone-iodine . Am J Ophthalmol . 1990;109:329-333. 11. Harbison MA, Hammer SM. Inactivation of human immunodeficiency virus by Betadine products and chlorhexidine . J Acquir Immune Defic Syndr . 1989;2:16-20. 12. De Potter P, Shields CL, Shields JA, Flanders AE, Rao VM. The role of magnetic resonance imaging in the evaluation of the hydroxyapatite orbital implant. Ophthalmology. In press. 13. Piecuch JF, Topazian RG, Skoly S, Wolfe S. Experimental ridge augmentation with porous hydroxyapatite implants . J Dent Res . 1983;62:148-154.Crossref 14. Kenney EB, Lekovic V, Sa Ferreira JC, Han T, Dimitrijevic B, Carranza FA. Bone formation within porous hydroxapatite implants in human periodontal defects . J Periodontol . 1986;57:76-83.Crossref 15. Holmes RE. Bone regeneration within a coralline hydroxyapatite implant . Plast Reconstr Surg . 1979;63:626-630.Crossref 16. Sartoris DJ, Gershuni DH, Akeson WH, Holmes RE, Resnick D. Coralline hydroxyapatite bone graft substitutes: preliminary report of radiographic evaluation . Radiology . 1986;159:133-137.Crossref 17. White E, Shors EC. Biomaterial aspects of Interpore-200 porous hydroxyapatite . Dent Clin North Am . 1986;30:49-67. 18. Rosen HM. Surgical correction of the vertically deficient chin . Plast Reconstr Surg . 1988;82:247-255.Crossref 19. Piecuch JF. Extraskeletal implantation of porous hydroxyapatite ceramic . J Dent Res . 1982;61:1458-1460.Crossref 20. Shields CL, Shields JA, Eagle RC, De Potter P. Hydroxyapatite orbital implant: histopathologic evidence of fibrovascular ingrowth four weeks after implantation . Am J Ophthalmol . 1991;111:363-366. 21. Ellsworth RM. Orbital retinoblastoma . Trans Am Ophthalmol Soc . 1974;72:79-88. 22. Kolberg GI. Fitting the Perry direct motility hydroxyapatite implant . J Am Soc Ocularists . 1988;19:35-38. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Hydroxyapatite Orbital Implant After Enucleation Experience With Initial 100 Consecutive Cases

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Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1992.01080150031022
Publisher site
See Article on Publisher Site

Abstract

Abstract • The hydroxyapatite orbital implant is designed to provide the enucleated patient with improved motility of the prosthesis. We report the results of our first 100 consecutive cases of hydroxyapatite implantation in eyes enucleated primarily for intraocular neoplasms. During a median of 11 months' follow-up, there have been no cases of orbital infection, implant extrusion, or implant migration. Minor postoperative problems have included transient orbital pain in six patients, Tenon's fascia edema and buried peg from tissue overgrowth in two patients each, wound erosion and peg extrusion in one patient each, and audible click of the peg in three patients. Movement of the socket and fornices was excellent in 99% of patients. Motility was cosmetically satisfactory with 10° to 15° rapid darting prosthesis movement present in 96% of patients regardless of whether the peg had been placed. Large-degree prosthesis motility (>15°) was present in 24% of all patients and was most impressive in those adults who had the peg in place and in children. The hydroxyapatite implant appears to be well tolerated and provides prosthesis motility with few problems. References 1. Shields JA, Shields CL. Intraocular Tumors: A Text and Atlas . Philadelphia, Pa: WB Saunders Co; 1991:37-41. 2. Soll DB. The anophthalmic socket . Ophthalmology . 1982;89:407-423.Crossref 3. Gougelmann HP. The evolution of the ocular motility implant . In: Shannon GM, Connelly FJ, eds. Oculoplastic Surgery and Prosthetics . Boston, Mass: Little Brown & Co Inc; 1970:689-711. 4. Kennedy RE. Enucleation, evisceration, and exenteration . In: Iliff NT, ed. Complications in Ophthalmic Surgery . New York, NY: Churchill Livingstone Inc; 1983:487-513. 5. Perry AC. Advances in enucleation . Ophthal Plast Reconstr Surg . 1991;4:173-177. 6. Perry AC. Integrated orbital implants . In: Bosniak SM, Smith BC, eds. Advances in Ophthalmic Plastic and Reconstructive Surgery . Elmsford, NY: Pergamon Press Inc; 1990:75-81. 7. Wolter JR. Tenonectomy: treatment of epibulbar extension of choroidal melanomas . Arch Ophthalmol . 1971;86:529-533.Crossref 8. Nerad JA, Hurtig RR, Carter KD, Bulgarelli DM, Yeager DC. A system for measurement of prosthetic eye movements using a magnetic search coil technique . Ophthal Plast Reconstr Surg . 1991;7:31-40.Crossref 9. Dutton JJ. Corallin hydroxyapatite as an ocular implant . Ophthalmology . 1991;98:370-377.Crossref 10. Benevento WJ, Murray P, Reed CA, Pepose JS. The sensitivity of Neisseria gonorrhoeae, Chlamydia trachomatis, and herpes simplex type II to disinfection with povidone-iodine . Am J Ophthalmol . 1990;109:329-333. 11. Harbison MA, Hammer SM. Inactivation of human immunodeficiency virus by Betadine products and chlorhexidine . J Acquir Immune Defic Syndr . 1989;2:16-20. 12. De Potter P, Shields CL, Shields JA, Flanders AE, Rao VM. The role of magnetic resonance imaging in the evaluation of the hydroxyapatite orbital implant. Ophthalmology. In press. 13. Piecuch JF, Topazian RG, Skoly S, Wolfe S. Experimental ridge augmentation with porous hydroxyapatite implants . J Dent Res . 1983;62:148-154.Crossref 14. Kenney EB, Lekovic V, Sa Ferreira JC, Han T, Dimitrijevic B, Carranza FA. Bone formation within porous hydroxapatite implants in human periodontal defects . J Periodontol . 1986;57:76-83.Crossref 15. Holmes RE. Bone regeneration within a coralline hydroxyapatite implant . Plast Reconstr Surg . 1979;63:626-630.Crossref 16. Sartoris DJ, Gershuni DH, Akeson WH, Holmes RE, Resnick D. Coralline hydroxyapatite bone graft substitutes: preliminary report of radiographic evaluation . Radiology . 1986;159:133-137.Crossref 17. White E, Shors EC. Biomaterial aspects of Interpore-200 porous hydroxyapatite . Dent Clin North Am . 1986;30:49-67. 18. Rosen HM. Surgical correction of the vertically deficient chin . Plast Reconstr Surg . 1988;82:247-255.Crossref 19. Piecuch JF. Extraskeletal implantation of porous hydroxyapatite ceramic . J Dent Res . 1982;61:1458-1460.Crossref 20. Shields CL, Shields JA, Eagle RC, De Potter P. Hydroxyapatite orbital implant: histopathologic evidence of fibrovascular ingrowth four weeks after implantation . Am J Ophthalmol . 1991;111:363-366. 21. Ellsworth RM. Orbital retinoblastoma . Trans Am Ophthalmol Soc . 1974;72:79-88. 22. Kolberg GI. Fitting the Perry direct motility hydroxyapatite implant . J Am Soc Ocularists . 1988;19:35-38.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Mar 1, 1992

References

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