Related Experiment Video
Updated: May 6, 2026
08:18
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
993
Extruded, partially disintegrated, poly-HEMA orbital implant (AlphaSphere)
Prashant Yadav1, Frederick A Jakobiec, Dawn K De Castro
1*Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; †Ophthalmic Plastic and Reconstructive Surgery, and ‡David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Ophthalmic Plastic and Reconstructive Surgery
|October 23, 2013
Summary
A 54-year-old man experienced orbital implant failure due to noninfectious disintegration of a hydroxyethyl methacrylate (HEMA) sphere. Histopathology revealed a granulomatous response, indicating a significant host tissue reaction to the poly-HEMA implant.
Area of Science:
- Ophthalmology
- Biomaterials Science
- Histopathology
Background:
- Enucleation for endophthalmitis necessitates orbital reconstruction.
- Secondary orbital implants, such as hydroxyethyl methacrylate (HEMA) spheres, are used to restore orbital volume and support ocular prosthesis.
Observation:
- A 54-year-old diabetic patient developed noninfectious disintegration of a poly-HEMA orbital implant six weeks post-insertion.
- The implant fragmentation affected Tenon's capsule, rectus muscle, and conjunctiva, necessitating removal to prevent extrusion.
Findings:
- Histopathologic analysis showed no infectious pathogens or tissue necrosis.
- The primary finding was the breakup of the poly-HEMA implant material, triggering a granulomatous inflammatory response.
- The inflammatory infiltrate consisted of sparse T-lymphocytes and minimal polymorphonuclear leukocytes.
Implications:
- This case highlights a potential complication of poly-HEMA orbital implants, characterized by implant disintegration and a foreign body granulomatous reaction.
- Further investigation is required to determine the frequency of this complication and optimize implant design or surgical techniques.
- Rigorous histopathologic examination is crucial for diagnosing such implant-related complications.
