title: Primary placement of a titanium motility post in a porous polyethylene orbital implant: animal model with quantitative assessment of fibrovascular ingrowth and vascular density.
abstract: OBJECTIVE
  To determine whether a Medpor porous polyethylene orbital implant, at the time of initial orbital implant surgery, will tolerate the insertion of a titanium screw on the anterior surface of the implant.
  
  
  METHODS
  Twelve New Zealand white rabbits were enucleated and implanted with a porous polyethylene orbital implant. At the time of enucleation, the porous polyethylene orbital implants were drilled, and titanium motility coupling posts were inserted. The motility coupling posts were inserted at two projection heights (2 or 4 mm) and either covered within Tenon capsule/conjunctiva (eight implants) or left exposed (four implants). Rabbits were killed at 6 or 12 weeks. Clinical tissue tolerance, histologic response to the motility coupling post, and vascular density of the porous polyethylene orbital implant were evaluated.
  
  
  RESULTS
  The motility coupling posts were well tolerated, and extrusion or migration of the motility coupling post did not occur. The average percentage cross-sectional area of the implant occupied by fibrovascular tissue at 6 and 12 weeks was 76.3% and 97.5%, respectively. In comparing the vascular density (number of vessels per square millimeter) in the porous polyethylene orbital implant within a 1-mm zone immediately surrounding the motility coupling post, no significant difference between this zone and the vascular density found within its entire corresponding annulus was found at either 6 or 12 weeks.
  
  
  CONCLUSIONS
  During the 6- and 12-week observation periods, all implanted motility coupling posts demonstrated favorable tissue tolerance and stable interfaces with surrounding tissues. The extent of fibrovascular tissue ingrowth and vascular density verify that initial screw insertion does not adversely affect the healing process after porous polyethylene orbital implant implantation. Thus, primary placement of the motility coupling post may obviate the need for a secondary surgical procedure.
authors.affiliation: Massachusetts Eye and Ear Infirmary, Ophthalmic Plastics, Orbital, and Cosmetic Eyelid Surgery, Boston, USA.
authors.forename: W C
authors.initials: WC
authors.lastname: Hsu
authors.forename: J P
authors.initials: JP
authors.lastname: Green
authors.forename: M H
authors.initials: MH
authors.lastname: Spilker
authors.forename: P A
authors.initials: PA
authors.lastname: Rubin
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D001863:Bone Screws; D015353:Eye Enucleation; D005133:Eye Movements; D005260:Female; D005347:Fibroblasts / Q000473:pathology; D018919:Neovascularization, Physiologic; D009915:Orbit / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D020273:Orbital Implants; D011095:Polyethylenes; D016062:Porosity; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D011817:Rabbits; D014025:Titanium
chemical_list: D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes; D014025:Titanium