Management of tissue breakdown and exposure associated with orbital hydroxyapatite implants

A new surgical approach for the management of tissue breakdown and exposure of an orbital hydroxyapatite (HA) implant is presented. The implant was placed after evisceration of an atrophic globe. Tissue breakdown and exposure developed 3 weeks after implantation. After a 3-month waiting period for spontaneous healing, a pedicled conjunctival flap from the lower eyelid was fashioned to cover the defect. This technique can be used to cover conjunctival defects over HA implants and is specifically recommended for large defects.