Clinical Report of Hydroxyapatite Orbital Implant

ABSTRACT

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.