Unwrapped hydroxyapatite orbital implants: our experience in 347 cases.

Area of Science:

• Ophthalmology
• Orbital Surgery
• Reconstructive Surgery

Background:

• Enucleation is a common procedure for various ocular pathologies.
• Hydroxyapatite (HA) implants are widely used for orbital reconstruction.
• The necessity of wrapping HA implants remains a subject of debate.

Purpose of the Study:

• To evaluate the outcomes of enucleations with primary insertion of unwrapped hydroxyapatite (HA) orbital implants.
• To assess complication rates and identify factors contributing to successful outcomes.

Main Methods:

• Retrospective review of 347 consecutive enucleations with primary HA implant insertion.
• Implants were placed posteriorly with recti muscles sutured end-to-end.
• Data collected on indications, implant size, follow-up duration, and complications.

Main Results:

• Tumor pathology (59.7%) and painful blind eye (40.3%) were primary indications.
• Average follow-up was 3.5 years.
• Low complication rates observed: implant exposure (1.2%), post-enucleation socket syndrome (11.5%), chronic discharge (9.2%).

Conclusions:

• Absence of wrapping material does not compromise HA orbital implant outcomes.
• Reduced surgical time and avoidance of wrapping-related complications are benefits.
• Posterior implant placement and end-to-end recti suturing enhance surgical success.