Bovine hydroxyapatite orbital implant: a preliminary report.
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.
Perry
Julian D
JD
Department of Ophthalmic Plastics and Orbital Surgery, Division of Ophthalmology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. perryj1@ccf.org
Goldberg
Robert Alan
RA
McCann
John D
JD
Shorr
Norman
N
Engstrom
Robert
R
Tong
John
J
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
D001672:Biocompatible Materials; D006882:Hydroxyapatites; D019786:Gadolinium DTPA