Porous polyethylene (Medpor) orbital implants with primary acellular dermis patch grafts

To evaluate the results of the porous polyethylene (Medpor) orbital implantation technique combined with the use of a primary patch graft of acellular dermis.

The study design was a retrospective, non-comparative single surgeon case series of 27 patients. The Medpor orbital implant was placed with a primary anterior sub-Tenon's acellular dermis patch after evisceration (23/27), enucleation (2/27) or implant exchange/secondary implant procedure (2/27) over a period of 3 years. Risk factors for dehiscence/complications were defined as trauma, infection, inflammation, previous ocular surgery, radiotherapy, secondary orbital implantation, and removal of extruding implants. The primary outcome measure was the development of implant exposure. Other complications were also recorded, including postoperative conjunctival wound dehiscence.

Twenty-five patients (93%) had more than 2 risk factors. Mean follow-up time was 22 months (median 24 months, range 4-34 months). Three (11%) patients needed further intervention, which included pyogenic granuloma excision (1) and fornix formation (1). Conjunctival wound dehiscence followed by implant exposure occurred in 1 of 27 eyes (3.7%). The cosmetic appearance was satisfactory in 26/27 patients.

Our results with primary acellular dermis grafts when coupled with Medpor orbital implantation are encouraging.