Clinical Experiences of Hydroxyapatite Implantation

ABSTRACT

Hydroxyapatite which has been used as bone substitute in orthopedic and maxillofacial surgery is used as ocular implant recently. It has been shown to be completly biocompatable, nontoxic and nonallegic so less extrusion and migration develop. We performed 37 cases of hydroxyapatite implantation 20 cases(51.4%) after evisceration, 8 cases(21.6%) after enucleation and 9 cases(24.3%) secondarily for the better prosthetic motility. Wound dehiscence developed in 6 cases(16.2%) 2 cases(10.0%) after evisceration, 2 cases(25.0%) after enucleation and 2 cases(22.2%) after secondary hydroxyapatitie implanation. Wound dehiscence was managed with dermis graft in 1 case and healed spontaneously in 1 case. Another 4 cases are under observation to expect the wound dehiscence to heal spontaneously. But no extrusion, migration and infection of implant were noted. We thought that wound dehiscence after hydroxyapatite implantation was related to conjunctival damage and atrophy by coarse surface of hydroxyapatite implant. Wound dehiscence can develop after hydroxyapatite implantation but careful patient selection and reducing tissue damage during surgery may alleviate the problems of wound dehiscence.