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[Complications of hydroxyapatite orbital implants in children: a series of 105 cases]
L Lumbroso1, C Levy, C Plancher
1Service d'Ophtalmologie, Institut Curie, Paris, France.
Insights
Hydroxyapatite orbital implants in children after enucleation can cause complications like chronic conjunctival erosion, though overall rates are comparable to adults. Further use is still warranted due to better tolerance than other implant types.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Biomaterials
Background:
- Hydroxyapatite orbital implants are used after enucleation.
- Data on pediatric complications is limited.
Purpose of the Study:
- Describe complications of hydroxyapatite orbital implants in pediatric patients post-enucleation.
- Identify risk factors for these complications.
Main Methods:
- Retrospective chart review of pediatric patients (1991-1998).
- Analysis of enucleation with hydroxyapatite implant placement.
- Specific focus on conjunctival, extrusion, and eyelid complications.
- Statistical analysis for risk factors.
Main Results:
- 105 implants used; 26.7% complication rate over 22 months median follow-up.
- Chronic conjunctival erosion (15%), conjunctival lesions (4.75%), implant extrusion (1.9%).
- No eyelid lesions observed; 75% treatment success rate.
- No significant risk factors identified.
Conclusions:
- Complications occur in pediatric hydroxyapatite orbital implants, similar to adults.
- Hydroxyapatite implants appear better tolerated than other types.
- Continued use is supported despite observed complications.
Purpose:
To describe the complications encountered using hydroxyapatite as an orbital implant in the pediatric population after enucleation, and try to define the risk factors for their occurrence.
Material:
and methods: Retrospective review of charts of children who underwent enucleation with placement of an hydroxyapatite implant between January 1991 and 1998. Complications and their type (conjunctival, extrusion, eyelids complications) have been specifically looked for. A statistical analysis trying to isolate the risks factors was performed.
Results:
105 implants have been used during this period with 26.7% of complications appearing during a median followup of 22 months. Extrusion of the implant was observed in 1.9% of the cases, a chronic conjunctival erosion in 15%, a conjunctival lesion without erosion in 4.75% and no eyelid lesion could be seen. Treatment (medical or surgical) achieved 75% good results. No risk factor could be found.
Conclusion:
Hydroxyapatite orbital implants were initially thought to have no or few complications. More recently, chronic erosions in particular were described. Little data exists on the pediatric population. Our series confirms that complications occur and that they are comparable to the adult population. Nevertheless the hydroxyapatite orbital implant seems better tolerated than other porous or non porous implants and warrants its use.
