Evisceration with Hydroxyapatite Implant: Surgical Technique and Review of 31 Case Reports

Published on Oct 1, 1995in Ophthalmology8.47
· DOI :10.1016/S0161-6420(95)30833-0
David A. Kostick1
Estimated H-index: 1
(WVU: West Virginia University),
John V. Linberg27
Estimated H-index: 27
(WVU: West Virginia University)
Sources
Abstract
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.
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