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Porous polyethylene orbital implant in the pediatric population
Vasiliki Iordanidou1, Patrick De Potter
1Ocular Oncology Unit, Cliniques Universitaires St-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
Insights
Primary porous polyethylene orbital implants in children show low complication rates. This study found few issues like pyogenic granuloma or implant exposure in pediatric patients.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Biomaterials Science
Background:
- Orbital implants are crucial for restoring aesthetics and function after enucleation in pediatric patients.
- Porous polyethylene orbital implants offer biocompatibility and potential for tissue integration.
- Complication rates of primary porous polyethylene orbital implants in the pediatric population require further investigation.
Purpose of the Study:
- To determine the incidence of complications associated with primary insertion of porous polyethylene orbital implants in pediatric patients.
- To evaluate the safety and tolerability of anteriorly wrapped spherical porous polyethylene orbital implants in children.
Main Methods:
- Prospective, nonrandomized interventional case series.
- 36 pediatric patients (<15 years) underwent primary placement of an anteriorly wrapped spherical porous polyethylene orbital implant.
- Follow-up averaged 44 months (range, 17-68 months).
Main Results:
- The study included 36 eyes of 36 pediatric patients with a mean age of 4.6 years.
- Complications included one case of pyogenic granuloma (3%) and one case of implant exposure (3%).
- No cases of implant extrusion, superior sulcus syndrome, or significant inflammatory response were observed.
Conclusions:
- Primary porous polyethylene orbital implants, when anteriorly wrapped, are well-tolerated in the pediatric population.
- The incidence of major complications is low, suggesting a favorable safety profile.
- Further research may explore long-term outcomes and peg placement in this cohort.
Purpose:
To determine the incidence of complications of primary insertion of porous polyethylene orbital implant in the pediatric population.
Design:
Interventional case series.
Methods:
Prospective nonrandomized case series of 36 eyes of 36 patients under age 15 years who underwent primary placement of an anteriorly wrapped spherical porous polyethylene orbital implant from March 1998 to August 2002, with at least 17 months of follow-up.
Results:
The mean age at the time of surgery was 4.6 years. The histopathologic diagnoses after enucleation included intraocular tumor in 22 patients, phthisis bulbi in eight patients, microphthalmos in three patients, Coats disease in two patients, and ruptured traumatic globe in one patient. Twelve patients (33%) had prior ocular surgery. At the time of enucleation, all patients underwent primary placement of spherical porous polyethylene orbital implant anteriorly wrapped with homologous sclera in 30 patients (83%) and autologous sclera in six patients (17%). The spherical implant size was 16 mm in one patient (3%), 18 mm in 10 patients ( 28%), and 20 mm in 25 patients (69%). The prosthesis was fitted after a mean interval of 5 weeks. After a mean follow-up of 44 months (range, 17 to 68 months), there was one case of pyogenic granuloma (3%) and one case of implant exposure (3%). There were no cases of implant extrusion, superior sulcus syndrome, orbital cellulitis, or significant inflammatory response. No porous polyethylene orbital implant was drilled for peg placement.
Conclusions:
Anteriorly wrapped primary porous polyethylene orbital implant in the pediatric population appears to be well tolerated with few complications.
