title: Exposure of expanded polytetrafluoroethylene-wrapped hydroxyapatite orbital implant: a report of two patients.
abstract: OBJECTIVE
  Hydroxyapatite (HA) spheres used to replace volume after an enucleation are often wrapped with autologous tissue before orbital implantation. Man-made materials are less expensive and pose no risk for viral transmission. The use of expanded polytetrafluoroethylene (ePTFE) to wrap HA spheres was evaluated.
  
  
  METHODS
  The medical records of 2 consecutive patients who underwent uncomplicated implantation of an HA sphere wrapped in ePTFE were reviewed.
  
  
  RESULTS
  An unusual reaction to the ePTFE material that was nonresponsive to topical or systemic antibiotic therapy developed in these 2 patients. Eventual wound erosion and bacterial infection of the implant necessitated its removal.
  
  
  CONCLUSIONS
  Although well tolerated in other surgeries, ePTFE, when used to wrap HA spheres and placed into the orbit, may cause persistent conjunctival discharge, pyogenic granuloma formation, and eventual wound erosion. Therefore, the use of this material to wrap HA spheres is not recommended.
authors: Department of Ophthalmology, University of California Davis, Sacramento, USA.
authors: P H
authors: PH
authors: Choo
authors: S R
authors: SR
authors: Carter
authors: J B
authors: JB
authors: Crawford
authors: S R
authors: SR
authors: Seiff
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017886:Durapatite; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D017789:Granuloma, Pyogenic / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D020273:Orbital Implants / Q000009:adverse effects* / Q000382:microbiology; D011138:Polytetrafluoroethylene; D012086:Reoperation; D013529:Surgical Wound Dehiscence / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene; D017886:Durapatite