Management of Exposed Hydroxyapatite Implant with Acellular Dermal Allograft

ABSTRACT

PURPOSE: To evaluate the clinical effect of AlloDerm(R) graft on the management of exposed hydroxyapatite orbital implants. METHODS: Seven eyes of 7 patients with large exposure of hydroxyapatite orbital implants were included. After the spicules of hydroxyapatite implants were smoothened with a drill, AlloDerm(R) was applied to the exposed site and sutured with 8-0 Vicryl. One or two layers of amniotic membrane were transplanted on the AlloDerm(R) graft. RESULTS: All patients underwent the drilling, and the mean intervals from drilling to exposure was 73.4 +/- 46.6 months. The mean follow-up period was 11.17 +/- 2.0 months (range, 9-14 months). Complete conjunctival epithelization occurred in 3 eyes, and partial conjunctival epithelization in 3, including one eye which underwent reoperation with AlloDerm(R). In one eye which had been associated with previous infection, hydroxyapatite was removed due to progressive exposure and inflammation of the implant. CONCLUSIONS: AlloDerm(R) graft is useful in the management of exposed hydroxyapatite implant.