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Updated: May 2, 2026
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Management of porous orbital implants requiring explantation: a clinical and histopathological study
Francesco M Quaranta-Leoni1, Caterina Moretti, Sabrina Sposato
1*Orbital and Adnexal Service, Department of Ophthalmology, †Department of Pathology, Villa Tiberia Hospital, Via Emilio Praga;and ‡Department of Ophthalmology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, Roma, Italy.
Purpose:
To perform a histopathological review of exposed porous orbital implants requiring explantation and to study the clinical outcome of replacement of the exposed implant with an autologous dermis-fat graft.
Methods:
Case series. Analysis of the clinical charts of 25 patients (age 5 to 62 years) who were submitted to explantation of exposed hydroxyapatite orbital implants, followed by simultaneous replacement with a dermis-fat graft by 1 oculoplastic surgeon between 2000 and 2011. A histopathological and microbiological evaluation of implant sections was performed. This study adheres to the principles outlined in the Declaration of Helsinki.
Results:
Microbiological examination showed the presence of Gram-positive cocci infection in 59% of the patients. Histopathological examination showed the presence of a chronic inflammatory infiltrate in 22 of the implants (88%) and significantly reduced fibrovascular colonization of the implant in all patients.
Conclusions:
The reduction of fibrovascular ingrowth resulted in poor integration of the implant in the eye socket. The exposure allowed bacterial colonization of the implant, causing a chronic inflammatory infiltrate. A dermis-fat graft at the same time of explantation can be considered a suitable surgical option in both adults and children: only minor complications may occur, and cosmetic results are satisfactory.
