Hydroxyapatite implantation with scleral quadrisection after evisceration

Few studies have examined hydroxyapatite (HA) use during evisceration procedures. While enucleation has been widely studied, evisceration with HA implantation remains underreported. Prior research has shown that HA implants can integrate well in orbital structures. However, the risk of implant exposure remains a concern in some cases. No prior work had resolved how to reduce this risk effectively. This gap motivated the exploration of surgical modifications to improve outcomes. The authors sought to determine if a specific surgical approach could enhance cosmetic and functional results. Their work aimed to provide a safer alternative for patients undergoing evisceration.

The authors aimed to assess the effectiveness of scleral quadrisection in evisceration procedures involving HA implants. They wanted to determine if this method could reduce implant exposure and improve cosmetic outcomes. The specific problem addressed was the high exposure rate of HA implants in evisceration cases. The motivation came from the lack of sufficient data on this surgical modification. The authors proposed that quadrisection could stabilize the implant and prevent complications. They also wanted to evaluate patient satisfaction with prosthetic motility. The study focused on cosmetic appearance and implant stability as primary outcomes. Their goal was to establish a reliable surgical protocol for HA implantation after evisceration.

The authors conducted a clinical study involving 17 patients who underwent HA implantation with scleral quadrisection after evisceration. Each patient received an HA implant measuring at least 18 mm in diameter. The surgical procedure included removing the eye contents and placing the implant. Scleral quadrisection was performed to secure the implant in position. Postoperative follow-up averaged 10.7 months in duration. The researchers monitored for complications such as conjunctival erosion and implant migration. Orbital bone SPECT scans were conducted to assess implant integration. Patient satisfaction and prosthetic motility were also evaluated during follow-up visits.

The study found no cases of conjunctival erosion or HA exposure during the follow-up period. None of the patients experienced implant migration or significant enophthalmos. The authors observed no superior sulcus deformity in any of the 17 cases. Seven patients had a ball-and-socket prosthesis and reported satisfaction with motility. Orbital bone SPECT scans showed complete uptake in all 10 studied patients after 11 weeks. The cosmetic appearance was rated as satisfactory by all participants. The HA implants remained stable and well-integrated in the orbital cavity. These findings suggest that scleral quadrisection may help prevent implant exposure after evisceration.

The authors concluded that scleral quadrisection is a safe and effective method for HA implantation after evisceration. Their findings suggest that this technique may reduce the risk of implant exposure and improve cosmetic outcomes. The study supports the use of quadrisection to stabilize HA implants in the orbital cavity. The authors propose that this approach could enhance patient satisfaction with prosthetic motility. No significant complications were reported in the 17 cases studied. Orbital bone SPECT results indicated successful implant integration. The authors suggest that this procedure may be beneficial for patients undergoing evisceration. Their results may guide surgeons in selecting appropriate implantation techniques.