Purpose: To evaluate the use of hydroxyapatite (HA) as an orbital implant with evisceration. Background: Although several reports have documented good success with HA orbital implants and their use with enucleation, only a few reports mention HA with evisceration. These few reports are less favorable, with exposure rates as high as 67%. In contrast, the authors have had good success with evisceration and HA implants with no major complications and a low exposure rate. Methods: A retrospective analysis of all eviscerations with HA implant performed between January 1989 and July 1993 was completed (n = 31). Patients underwent evisceration with scleral modification, including anterior relaxing incisions and posterior sclerotomies to accommodate a large sphere without tension on the wound. Patient records were reviewed for demographic data, surgical indication, sphere size, clinical outcome, complications, and follow-up interval. The surgical technique is described. Results: All 31 patients underwent successful surgery with complications limited to exposure (6%), mild superior sulcus deficit (6%), and a conjunctival cyst (3%). No patient required further socket reconstruction, and no patient required peg placement to enhance motility. The average follow-up interval was 13.3 months. Conclusions: The authors have had good success using HA orbital implants for evisceration without major complications. Primary evisceration with HA implantation after posterior sclerotomies is a safe and effective method for treating patients with a blind, painful eye.
: This paper reported combined sternohyoid myocutaneous flap and hydroxyapatite (HA) graft for laryngotracheal reconstruction in clinical and experimental studies. HA rings were employed for reconstructing the laryngotracheal framework in 10 patients on the base of animal experiment. The implant was well taken in all cases without any rejection, resulting in excellent airways. The study demonstrates that this procedure can be used in treatment of severe laryngotracheal stenosis.
#2Grant W. Heinz(IUPUI: Indiana University – Purdue University Indianapolis)H-Index: 7
Last. Mark A. Cepela(IUPUI: Indiana University – Purdue University Indianapolis)H-Index: 1
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: We retrospectively reviewed enucleations and secondary anophthalmic socket sphere implantations for a 3 year period. We compared the incidence of exposure of hydroxyapatite implants to the incidence of exposure of silicone implants. We found that the incidence of hydroxyapatite exposure following enucleation was 3 of 27 (11.1%), and following secondary anophthalmic socket implantation was 3 of 32 (9.4%). The incidence of silicone sphere exposure following enucleation was 0 of 48 (0%), and foll...
Tissue breakdown and exposure of a hydroxyapatite implant were observed in eight patients: in four of six patients after evisceration and in four of 31 after enucleation. The reasons for evisceration were a blind, painful eye and endophthalmitis in two patients each. The reasons for enucleation were a choroidal melanoma in two patients and endophthalmitis and irreparable traumatic damage in one patient each. The patients with endophthalmitis received the implant in a second surgical procedure af...
Twelve patients received a coralline hydroxyapatite sphere as a buried integrated ocular implant after enucleation surgery. The implant was modified by drilling 5 access holes, 1 mm in diameter, to the center of the sphere to allow more rapid host tissue ingrowth. 99Tc MDP static and dynamic bone scan studies were performed at various intervals after implantation to confirm the time course for vascularization. Complete vascularization was noted in 1 of 2 patients at 8 weeks after surgery, in 7 o...
• The hydroxyapatite orbital implant is designed to provide the enucleated patient with improved motility of the prosthesis. We report the results of our first 100 consecutive cases of hydroxyapatite implantation in eyes enucleated primarily for intraocular neoplasms. During a median of 11 months' follow-up, there have been no cases of orbital infection, implant extrusion, or implant migration. Minor postoperative problems have included transient orbital pain in six patients, Tenon's fascia edem...
Abstract Fifty patients received a coralline hydroxyapatite sphere as a buried integrated ocular implant after enucleation or evisceration surgery. The surgical technique is described and the results discussed. All patients obtained final prosthetic motility superior to that possible with simple spherical methylmethacrylate implants. After a follow-up of 2 to 27 months (mean, 10.4 months) there have been no cases of migration or extrusion. Complications have been minimal and easily managed. The ...
We studied the histopathologic findings after placement of an orbital hydroxyapatite implant in a patient. The implant was placed after enucleation for a choroidal melanoma and was removed four weeks later because histopathologic examination of the enucleated globe disclosed tumor invasion of the optic nerve that necessitated further orbital tissue removal. Our histopathologic findings confirm that there is significant ingrowth of fibrovascular tissue in these implants, even within weeks of impl...
The surgical technique of placing the implant deep within the muscle cone, the use of autologous or homologous tissue to wrap the implant, and the use of newer synthetic materials all show promise in improving the reconstruction of the enucleated socket
Hydroxylapatite plates and rings were employed for reconstruction of the laryngotracheal framework in 12 patients. The cause of the framework defect was surgery for stenosis in nine cases and removal of malignancy in the other three. The trough method associated with a two-stage procedure was tolerated in all 12 cases. Hydroxylapatite plates or rings were used to reconstruct the framework during the second stage
#1Ju Mi Kim(CNU: Chungnam National University)H-Index: 1
#2Jae Yun Sung(CNU: Chungnam National University)H-Index: 2
Last. Sung Bok Lee(CNU: Chungnam National University)H-Index: 8
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This study analyzed risk factors for extrusion of orbital implants after evisceration by comparing patients with and without implant extrusion. Methods: We retrospectively reviewed the medical records of patients who underwent evisceration with primary implant placement by a single surgeon from January 2005 to December 2019 at the Chungnam National University Hospital. Age, sex, underlying systemic diseases, axial length of the fellow eye, the cause of evisceration, endophthalmitis type, implant...
Purpose:To compare the four-petal evisceration technique and the standard evisceration technique.Methods:In this retrospective, comparative case series study, sixteen charts of patients fulfilled t...
Last. Zoltán Nagy(Semmelweis University)H-Index: 4
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Our aims were to evaluate the primary and clinical evisceration indications and to analyse orbital implant related complications. We included in our retrospective review all eviscerations between 2006 and 2016 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary. Primary evisceration indications were classified into six groups: trauma, surgical diseases, infections or inflammations, systemic diseases, tumours and unclassifiable diseases. Clinical immediate evisceration ...
ABSTRACTIntroduction: To present long-term follow-up data on evisceration performed with autogenous scleral grafting and ceramic implantation in a modified scleral shell.Methods: This was a retrospective analysis of all consecutive eviscerations performed in the Department of Ophthalmology, Montpellier University Hospital, France, between February 1998 and October 2015. For all patients, the technique used was a conventional anterior evisceration after total keratectomy, disinsertion of the medi...
Purpose Conjunctival chemosis is a common, usually benign, complication of ocular and oculoplastic surgery. After enucleation, evisceration, or secondary ball implant, however, conjunctival edema can cause conformer extrusion, forniceal eversion, and shortening which may complicate the future fitting of a prosthesis. This longitudinal chart review aimed to estimate the efficacy of a temporary suture tarsorrhaphy to minimize postoperative edema and improve conformer retention.
To determine whether evisceration with optic nerve disinsertion and nonporous implant placement increases the risk of implant migration.This was a single-center, retrospective consecutive comparative interventional case series including patients undergoing evisceration with nonporous implant between January and December 2014. Patients were grouped into 2 groups: group I where the optic nerve was not disinserted (n = 37) and group II with optic nerve disinsertion (n = 50). Implant migration was a...
Purpose The aim of this study is to evaluate resident surgical performance based on complications after ocular evisceration. Methods A retrospective chart review of eviscerations performed between October 2011 and May 2017 by ophthalmology residents as the primary or assistant surgeon under the guidance of a single oculofacial plastic surgeon (M.O.G.) was completed. Data collected included reason for evisceration, resident participation in the case and resident's month of oculoplastic training, ...
Purpose:To determine the safety, durability, and biocompatibility of 2.5% polyacrylamide hydrogel (Aquamid, Specialty European Pharma, Ltd., London, UK) as an injectable viscoelastic implant following evisceration in a rabbit model.Methods:The protocol was reviewed and approved by the Wake Forest In
PURPOSE: To describe the results and potential benefit of placement of a porous orbital implant (aluminum oxide) posterior to posterior sclera and compare the exposure rate with a former evisceration technique involving a posterior sclerotomy with placement of a porous implant partly within the scleral shell and partly within the intraconal space. METHODS: Single-center, retrospective, interventional case series. A chart review of 93 patients undergoing evisceration with placement of an aluminum...
