Evisceration with Hydroxyapatite Implant

ABSTRACT

In contrast to the literature on the use of hydroxyapatite orbital implants with enucleation, reports of the use of hydroxyapatite implants with evisceration are limited and those that have been published reported high exposure rates. The authors described modified surgical technique of primary evisceration with hydroxyapatite implant and evaluated its effects on cosmetic appearance and the prevention of implant exposure. All 28 consecutive patients underwent evisceration with hydroxyapatite implant between December 1994 and April 1998. To place an appropriate hydroxyapatite implant into the scleral shell without tension we made a saw-tooth shaped large posterior sclerotomy around the optic nerve sparing 6-o`clock position to minimize the inferior displacement of the implant. In cases with very small globes we made 3 to 4 additional radial posterior sclerotomies. During the mean follow-up of 13.5 months, none of the patients experienced complications such as conjunctival erosion, hydroxyapatite exposure, implant extrusion, significant enophthalmos, or superior sulcus deformity. The authors have had good success without major complications using our modified surgical technique for hydroxyapatite orbital implants with evisceration.