title: Primary placement of a hydroxyapatite-coated sleeve in bioceramic orbital implants.
abstract: OBJECTIVE
  To study a new surgical option of primary placement of a hydroxyapatite-coated sleeve into the Bioceramic implant during enucleation or evisceration.
  
  
  METHODS
  Retrospective, observational case series.
  
  
  METHODS
  A standard enucleation or evisceration was performed, followed by the preplacement of a hydroxyapatite-coated sleeve into the Bioceramic implant. Care must be taken to ensure the sleeve has been positioned centrally when the implant is put inside the orbital socket. Complications such as sleeve exposure, Bioceramic implant exposure, and infection were closely observed.
  
  
  RESULTS
  Twenty-seven patients were treated in above fashion with five enucleation and 22 evisceration procedures. Five of the sleeves have exposed spontaneously during 1 to 4 months after original surgery. They had no further complication, except for one sleeve around which there were visible Bioceramic spicules attributable to long-term corticosteroid usage. The remaining 22 sleeves that did not spontaneously expose pursued secondary exposure of the sleeve and peg insertion by the conjunctival cutdown procedure 3 months postoperatively. One sleeve was medially positioned far away from the implant center. Re-insertion of new sleeve and peg was scheduled 2 weeks later. One additional sleeve was obliquely positioned after conjunctival cutdown procedure. Fortunately, all 27 patients were successfully fitted with a peg-coupled prosthesis with good motility.
  
  
  CONCLUSIONS
  Primary placement of a hydroxyapatite-coated sleeve into the Bioceramic implants has several advantages, including high patient acceptance, technical simplicity, and an office-based conjunctival cutdown pegging procedure. By avoiding the expense of postoperative imaging studies and additional prosthetic modification, a more rapid and efficient rehabilitation is possible.
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan. lang89@ha.mc.ntu.edu.tw
authors.forename: Shu Lang
authors.initials: SL
authors.lastname: Liao
authors.forename: Mei Ju
authors.initials: MJ
authors.lastname: Shih
authors.forename: Luke L-K
authors.initials: LL
authors.lastname: Lin
mesh_terms: D000328:Adult; D002516:Ceramics; D020099:Coated Materials, Biocompatible; D017886:Durapatite; D015353:Eye Enucleation; D017234:Eye Evisceration; D005137:Eye, Artificial; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D008297:Male; D009915:Orbit / Q000601:surgery*; D020273:Orbital Implants; D011183:Postoperative Complications; D017755:Prosthesis Fitting; D019919:Prosthesis Implantation; D012189:Retrospective Studies
chemical_list: D020099:Coated Materials, Biocompatible; D017886:Durapatite