Clinical analysis of orbital implantation and postoperative complications / 局解手术学杂志

Objective To discuss the cause, managment and prevention of the postoperative complications of orbital implantation by clinical case analysis, and to provide reference for the future clinical work. Methods 175 cases of orbital implantation from Aug. 2011 to Aug. 2013 were retrospectively analyzed in our department. The postoperative complications occurrence, related symptomatic treatment, and the reasons of complications were analyzed. Results Complications occurred in 175 cases of 9 cases(5. 14%),including 4 cases of the con-junctival cyst (2.29%),3 cases of orbital implants exposure(1.71%),1 case of orbital chronic infection(0.57%)and 1 case of subcon-junctival tissue atrophy(0. 57%). All of them had obtained good curative through cyst excision or orbital implanting again after the active treatment. There were no complication occurred again. Conclusion The postoperative complications should be positively analyzed, and early positive precaution could reduce most of the complications.

A Case of Candida Infection after Porous Polyethylene (Medpor(R)) Orbital Implantation

PURPOSE: To report a case of candida infection after Medpor(R) orbital implantation. METHODS: A 51-year-old man was admitted complaining of painful swelling and discharge about 3 years after orbital Medpor(R) implantation. External examination revealed signs of infection and exposure of the implant. Medpor(R) was surgically removed. In laboratory studies, white colony was detected in blood agar, potato dextrose agar, and CHROMagar. Automatic identification with yeast standard test revealed Candida parapsilosis. RESULTS: Six months after surgery, the wound had healed well. In addition, cosmesis was acceptable with the artificial eye, except mild superior sulcus deformity. CONCLUSIONS: Although rare, fungal infection of the implant should be suspected when there are the long standing signs of infection and exposure after orbital Medpor(R) implantation.

Bovine Pericardium as a Wrapping Material for Hydroxyapatite Orbital Implant

PURPOSE: To investigate the usefulness of a processed bovine pericardium(Lyoplant(R)) as a wrapping material for hydroxyapatite orbital implant. METHODS: The authors carried out hydroxyapatite orbital implantation with a processed bovine pericardium(Lyoplant(R)) as a wrapping material for hydroxyapatite sphere in 14 enucleation cases from October 1998 to May 2000, and evaluated postoperative complications, fibrovascular ingrowth and implant or prosthesis motility. RESULTS: Physical properties of bovine pericardium, such as tensile strength, flexibility, suture characteristics, were good. Complications were developed in 8 cases(5 eyes), but there was no serious complication such as an implant exposure. Fibrovascular ingrowth and implant or prosthesis motility were satisfactory. CONCLUSION: The authors suggest bovine pericardium(Lyoplant(R)) as an effective wrapping material for hydroxyapatite orbital implant.

Clinical Report of Hydroxyapatite Orbital Implant

Hydroxyapatite has been reported as an excellent orbital implant for good prosthetic motility without implant migration or protrusion. We performed hydroxyapatite orbital implantation in 102 patients between January 1992 and December 1995 ; 52 cases (50.8%) of evisceration, 43 cases (42.2%) of enucleation and 7 cases (7.0%) of secondary implantation for the better prosthetic motility. We performed 99mTc-MDP bone scan in 77 patients between 4 and 16 months (mean: 7.6 months) postoperatively. The 69 patients (89.6%) revealed radiotracer uptake over grade II. The 75 patients of 81 patients excellent cosmesis with satisfactory prosthetic motility. Conjunctival wound dehiscence were observed in 51 patients (50.0%) ; in 30 cases of evisceration, in 19 cases of enucleation, and in 2 cases of secondary implant. And hydroxyapatite implant exposure were developed in 17 patient (16.7%) ; in 14 cases of eviseration (82.4%) and 3 case of enucleation (17.6%). And 8 patients of exposed hydroxyapatite were healed spontaneously and another 4 patients are under observation to expect the wound dehiscence to heal spontaneously. Exposed hydroxyapatite implants with more than 5mm in diameter were managed with dermis graft in two cases, scleral patch graft in two cases and oral mucosal graft in one case. Hydroxyapatite orbital implant needed higher cost and longer duration until the full treatment, but it gave an excellent cosmetic reconstruction without any extrusion or unacceptable infection.