Hydroxyapatite implantation with scleral quadrisection after evisceration.
OBJECTIVE
In contrast to the literature on enucleation, reports of hydroxyapatite (HA) implantation during evisceration are limited; however, those that have been published mention the high HA exposure rate. The authors examined the scleral quadrisection procedure to evaluate its effect on cosmetic appearance and the prevention of HA exposure after evisceration.


METHODS
The authors analyzed the surgical outcomes of 17 patients who had undergone an HA implantation with scleral quadrisection after evisceration between November 1994 and November 1995.


RESULTS
In each case, the authors were able to use HA implants of 18 mm or more. During follow-up (average 10.7 months), there were no cases of conjunctival erosion, HA exposure, implant migration, significant enophthalmos, or superior sulcus deformity. All of the patients, 7 of whom had a ball- and-socket prosthesis, were satisfied with their cosmetic appearance and prosthetic motility. More than 11 weeks after evisceration, all 10 studied patients had complete, round uptakes with orbital bone SPECT (single photon emission computed tomography).


CONCLUSIONS
For good cosmetic appearance and for the prevention of implant exposure, scleral quadrisection is a safe and effective procedure for HA implantation after evisceration.
Yang
J G
JG
Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Khwarg
S I
SI
Wee
W R
WR
Kim
D M
DM
Lee
J H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D002648:Child; D002675:Child, Preschool; D017886:Durapatite; D017234:Eye Evisceration / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery; D017060:Patient Satisfaction; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon
D001672:Biocompatible Materials; D017886:Durapatite