title: Bovine pericardium versus homologous sclera as a wrapping for hydroxyapatite orbital implants.
abstract: OBJECTIVE
  To report our experience with bovine pericardium as a wrapping material for hydroxyapatite orbital implants after enucleation and to compare the exposure rates of the implants wrapped with bovine pericardium versus donor sclera.
  
  
  METHODS
  We retrospectively reviewed the records of all patients who received bovine pericardium-wrapped or donor sclera-wrapped hydroxyapatite implant after primary enucleation between March 1995 and December 2001.
  
  
  RESULTS
  Of the 26 patients who received donor sclera-wrapped implants after enucleation, 1 (3.8%) had implant exposure. Of the 26 patients who received bovine pericardium-wrapped implants after enucleation, 6 (23%) had implant exposure. The incidence of implant exposure with the use bovine pericardium wrapping material was found to be significantly higher than with sclera (P = 0.05). Six of the 7 implant exposures were noted in the first 6 months after placement of the orbital implant. Five of the 6 exposed bovine pericardium-wrapped hydroxyapatite implants were associated with socket infection. The case of exposure of the sclera-wrapped implant was treated conservatively by observation. Six patients who had exposure of bovine pericardium-wrapped implants required multiple repairs because of recurrent exposures. Four of these patients eventually required removal of the implant.
  
  
  CONCLUSIONS
  Despite the advantages of using bovine pericardium as a wrapping material for hydroxyapatite orbital implants, we observed a significantly higher incidence of exposure with bovine pericardium compared with donor sclera in the early postoperative period. Use of bovine pericardium as a wrapping material for orbital implants should be avoided unless some future modifications of the technique can be developed to prevent such complications.
authors.affiliation: Department of Ophthalmology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Yonca Ozkan
authors.initials: YO
authors.lastname: Arat
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Shetlar
authors.forename: Milton
authors.initials: M
authors.lastname: Boniuk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible / Q000009:adverse effects; D017886:Durapatite; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007223:Infant; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000209:etiology; D020273:Orbital Implants / Q000009:adverse effects; D010496:Pericardium; D012189:Retrospective Studies; D012590:Sclera
chemical_list: D020099:Coated Materials, Biocompatible; D017886:Durapatite