Hydroxyapatite implants--a new trend in enucleation and orbital reconstructive surgery.

As treatment modalities evolve in ophthalmology one must assess and re-evaluate current methods of therapy in the care and treatment of the patient facing the loss of an eye. With the advent of Hydroxyapatite Orbital Implants, new challenges face the ophthalmic nurse in caring for the patient undergoing enucleation and reconstructive surgery. Integrated orbital implants are used to replace the volume of the orbit when the eye is removed due to enucleation, evisceration, or as secondary orbital implants. Various materials have been used in the past to replace orbital volume, with the most common being silicone or polymethylmethacrylate. Hydroxyapatite is a new orbital implant material which has unique interconnected porous matrix derived from marine corals with a mineral composition similar to bone. This orbital implant undergoes fibrovascular ingrowth by the patient's own tissue, becoming truly integrated and less likely to reject, migrate or extrude. The hydroxyapatite implant may be inserted with a variety of surgical techniques, all of which are more complex than standard enucleation implant techniques and have special considerations for the ophthalmic registered nurse.

Hydroxyapatite orbital implants: indications for use and nursing considerations.

1. An orbital implant made of coralline hydroxyapatite is available as an enucleation, evisceration, or secondary orbital implant. This material is naturally occurring, nontoxic, nonallergenic, biocompatible, and resistant to infection. 2. Special nursing considerations, beginning with meticulous aseptic technique, are necessitated by the special preparation of the hydroxyapatite sphere for implantation. It is important to assess the patient's understanding of the surgical procedure, postoperative care regimen, and the importance of keeping follow-up appointments. 3. Coralline hydroxyapatite orbital implants undergo fibrovascular ingrowth, making them truly integrated orbital implants. Unique possibilities for prosthetic rehabilitation provide a significant improvement over previously available enucleation implants.