Integrated hydroxyapatite implant and non-integrated implants in enucleated Asian patients

Area of Science:

• Ophthalmology
• Biomaterials
• Reconstructive Surgery

Background:

• Orbital implants are used after enucleation to maintain orbital volume and support ocular prosthesis.
• Integrated hydroxyapatite implants and non-integrated implants (acrylic, glass, silicone) are common choices.
• Patient outcomes and complication rates can vary significantly between implant types.

Purpose of the Study:

• To compare the outcomes and complications of integrated hydroxyapatite orbital implants versus non-integrated implants in Asian patients following enucleation.
• To evaluate the incidence of implant migration, extrusion, socket infection, conjunctival dehiscence, and implant exposure.

Main Methods:

• Retrospective study conducted at Singapore National Eye Centre (1991-2000).
• Involved enucleated patients receiving either coralline hydroxyapatite implants or non-integrated implants (acrylic, glass, silicone).
• Statistical analysis utilized the 2-sample t-test to compare outcomes.

Main Results:

• Hydroxyapatite group (n=21) and non-integrated group (n=38) were analyzed.
• Non-integrated implants showed cases of migration (4), extrusion (4), and socket infection (3).
• Hydroxyapatite implants had a significantly higher rate of conjunctival dehiscence (6/21 vs 3/35, P=0.048).

Conclusions:

• Coralline hydroxyapatite orbital implants demonstrated a lower risk of migration, extrusion, and infection compared to non-integrated implants.
• A significantly higher rate of conjunctival dehiscence was observed with hydroxyapatite implants.
• Most complications were manageable, with few progressing to implant exposure.