Autogenous Temporalis Fascia Graftin Exposure of Hydroxyapatite Implant

Hydroxyapatite recently has been used for its excellent results compared with other implant materials, but the tissue breakdown and exposure of the hydroxyapatite implant was reported due to hemorrhage or infection. Five patients with exposed hydroxyapatite implant after evisceration or enucleation were studied.The hydroxyapatite implant exposure occurred in 2 to 8 weeks (mean 4.2 weeks)after implantation.Conjunctival defects with various sizes were noted in all cases and purulent discharge in one case. An autogenous temporalis fascia patch graft was placed instead of preserved sclera or fascia lata for the intensification of the defect area.No reexposure occurred during a follow-up examination and we could keep the implant well in all cases. The temporalis fascia is advantageous over preserved sclera or fascia lata because it is firm and can be easily obtained from the same operative field as the primary surgery.Therefore, it is thought to be suitable for graft material in surgery of the exposed hydroxyapatite.No scars are visible after obtaining temporalis fascia.

Effective Concentration of Mitomycin-C in Surgery for Primary Pterygium

The recurrent rate after pterygium surgery is about 30 to 50%and mitomycin-C has been used as soaking method during surgery or as instillation after surgery for reduction of the recurrence. To determine the effective concentration of mitomycin-C in soaking method during pterygium surgery, we reviewed 87 patients(95 eyes)who were divided into three groups with different concentrations of MMC. The application time was 5 minute and concentration of MMC was 0.1 mg/ml(n=31), 0.2 mg/ml(n=35), and 0.4 mg/ml(n=29), respectively. During the mean follow-up period of 8 months, recurrent rate was 16.1%(5eyes)in 0.1mg/ml group, 14.3%(5 eyes)in 0.2 mg/ml, and 13.8%(4 eyes)in 0.4 mg/ml group. This difference was not statistically significant(p>0.05). Complication rate was 6.5%(2 eyes)in 0.1 mg/ml group, 8.6%(3 eyes)in 0.2 mg/ml group, and 10.3%(3 eyes)in 0.4 mg/ml group;these results were also not statistically significant(p>0.05). In conclusion, it is desirable to use lower concentration of MMC in soaking method for prevention of the recurrence of primary pterygium surgery.