title: Bovine hydroxyapatite orbital implant: a preliminary report.
abstract: OBJECTIVE
  To determine the safety and efficacy of bovine hydroxyapatite as an orbital implant material.
  
  
  METHODS
  Prospective, consecutive case series of patients undergoing enucleation, evisceration, or secondary orbital implantation. A motility peg was placed in all consenting candidates. Patients were followed 1 week, 1 month, and several months after surgery for signs of inflammation, infection, extrusion, or other complication.
  
  
  RESULTS
  Twenty-seven patients received a bovine hydroxyapatite orbital implant. Magnetic resonance imaging was obtained in 3 patients (3 orbits) approximately 4 weeks after surgery and showed signs of peripheral fibrovascular ingrowth in all three cases. Magnetic resonance imaging was obtained in 9 patients (9 orbits) 4 to 12 months after surgery and showed signs of incomplete fibrovascular ingrowth in 1 of 9 (11%) cases, subtotal fibrovascular ingrowth in 2 of 9 (22%) cases, and complete fibrovascular ingrowth in 6 of 9 (67%) of cases. Complications included postoperative chemosis in 3 cases (11%) and exposure requiring reoperation in 2 cases (7%). Motility peg placement was performed successfully in 5 patients (5 orbits).
  
  
  CONCLUSIONS
  Bovine hydroxyapatite appears to be a safe and effective orbital implant material. The material appears to be biocompatible and nonallergenic. Bovine hydroxyapatite allows for fibrovascular integration and motility peg placement.
authors.affiliation: Department of Ophthalmic Plastics and Orbital Surgery, Division of Ophthalmology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. perryj1@ccf.org
authors.forename: Julian D
authors.initials: JD
authors.lastname: Perry
authors.forename: Robert Alan
authors.initials: RA
authors.lastname: Goldberg
authors.forename: John D
authors.initials: JD
authors.lastname: McCann
authors.forename: Norman
authors.initials: N
authors.lastname: Shorr
authors.forename: Robert
authors.initials: R
authors.lastname: Engstrom
authors.forename: John
authors.initials: J
authors.lastname: Tong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001672:Biocompatible Materials; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D015353:Eye Enucleation / Q000534:rehabilitation; D017234:Eye Evisceration / Q000534:rehabilitation; D005137:Eye, Artificial; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006882:Hydroxyapatites; D007223:Infant; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D020273:Orbital Implants; D016062:Porosity; D019919:Prosthesis Implantation / Q000379:methods*; D011859:Radiography; D012449:Safety; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D006882:Hydroxyapatites; D019786:Gadolinium DTPA