The Therapeutic Efficacy of Exposed Orbital Implant (Medpor(R)) Using Tenon's Capsule

ABSTRACT

PURPOSE: To evaluate the therapeutic efficacy of primary closure of subtenon's capsule contained with normal ocular blood vessels in the case of exposed porous orbital implant. METHODS: The subjects consisted of five patients who had failed dermis-fat grafts or scleral graft previously presented with re-exposed Medpor orbital implant and three patients who showed primary exposure of Medpor without other operations. We completely cured the exposed area of Medpor using subtenon capsule closure. The range of superficial exposed size of Medpor was about 3~8 mm 4~8 mm. Under local infiltration with 2% lidocaine, the contaminated superficial margin of Medpor was partially removed and then the subtenon's capsule was isolated from the conjunctiva and the orbital implant was directly sutured with Prolene 5-0 without any tension of ocular tissue. Finally, conjunctival suture was performed with Vicryl 7-0. RESULTS: Seven patients were healed well but one patients experienced a 1.5-mm sized. The exposure of Medpor was treated after re-operation using closure of the subtenon's capsule. The only complication observed were forniceal shortening and decreased orbital implant volume, but there ware no clinically significant complications in wearing artificial eyes. CONCLUSIONS: We succeed in complete recovery of exposed Medpor using tenon's capsule without tissue graft. When the Medpor exspoure was less than 1 X 1 cm, it should be useful a technique to repair the exposed surface by using primary closure of subtenon's capsule.