Clinical analysis of hydroxyapatite orbital implantation after ocular trauma in 211 cases / 中华创伤杂志(英文版)

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects and complications of hydroxyapatite (HA) orbital implantation on patients after trauma-related surgeries.</p><p><b>METHODS</b>Retrospective analysis was made from 211 cases (211 eyes) who underwent HA orbital implant placement after trauma-related enucleation or evisceration, including 68 cases of evisceration and primary HA implant placement, 77 cases of enucleation and HA implant placement wrapped with multi-windowed sclera, 66 cases of enucleation and HA implant placement free of wrapping. All the cases were followed up for 1-5 years to observe the therapeutic effects and major complications.</p><p><b>RESULTS</b>Five of 211 cases had wound dehiscence. Ten cases had HA implants exposure, including 1 case suffering severe orbital infection and requiring HA implant removal. The implants exposure incidences by the three surgical methods were from 1.30% to 10.06% and averaged 4.74%. Significant difference was found in late exposure incidence and total incidence from the three methods (chi(2)=13.372, P < 0.01 and chi(2)=7.540, P < 0.05). Two cases had shrinkage of the lower fornix. Enophthalmos occurred in 1 case treated by method 1 and was corrected by implanting porous polyethylene (Medpor) plate into the bottom of orbit. In 210 cases, the artificial eye moved well and the cosmetic results were satisfactory.</p><p><b>CONCLUSIONS</b>Different surgical methods have their own merit and disadvantage. Enucleation and placement of HA implant wrapped with multi-windowed sclera has corroborated fewer complications than others.</p>