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Problems with the hydroxyapatite orbital implant: experience with 250 consecutive cases

C L Shields1, J A Shields, P De Potter

  • 1Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107.

The British Journal of Ophthalmology
|September 1, 1994
PubMed
Summary

Coral-derived hydroxyapatite orbital implants offer excellent motility for prosthetic eyes after enucleation. This study of 250 cases found them well-tolerated with low complication rates, suggesting good prosthesis fit is key.

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Area of Science:

  • Ophthalmology
  • Biomaterials Science
  • Surgical Innovation

Background:

  • Coral-derived hydroxyapatite spheres are popular integrated orbital implants for prosthetic eye motility post-enucleation.
  • Limited data exists on complications associated with hydroxyapatite orbital implants in large patient series.

Purpose of the Study:

  • To investigate the complication rates and management strategies for hydroxyapatite orbital implants in a large cohort.
  • To evaluate the safety and efficacy of hydroxyapatite orbital implants in improving ocular prosthesis motility.

Main Methods:

  • Retrospective review of 250 consecutive cases using hydroxyapatite orbital implants.
  • Analysis of reasons for enucleation, prior ocular treatments, and implant-related complications.
  • Mean follow-up of 23 months (range 6-40 months).

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Main Results:

  • No cases of orbital hemorrhage, implant extrusion, or migration observed.
  • One case of presumed orbital infection resolved with antibiotics; implant retained.
  • Conjunctival thinning (8 cases) and erosion (4 cases) were managed successfully.
  • Prior radiotherapy or surgery did not increase complication rates.

Conclusions:

  • Hydroxyapatite integrated orbital implants are well-tolerated motility implants with low complication rates compared to other options.
  • Effective management of conjunctival issues and optimal prosthesis fit contribute to implant tolerance.
  • The hydroxyapatite implant demonstrates a favorable safety profile for orbital reconstruction.