Enucleation with unwrapped porous and nonporous orbital implants: a 15-year experience.
OBJECTIVE
To compare the rates of implant exposure and implant migration among patients who received an unwrapped nonporous spherical implant versus an unwrapped porous spherical implant immediately after enucleation.


METHODS
Retrospective analysis of a series of 258 patients who received either an unwrapped nonporous spherical implant (n = 68) or an unwrapped porous spherical implant (n = 190). Actuarial rates of migration of the implant and conjunctival dehiscence leading to implant exposure were computed.


RESULTS
Sixty-eight patients received an unwrapped nonporous implant (polymethylacrylate [PMMA]) and 190 patients received an unwrapped porous implant (139 hydroxyapatite [HA] and 51 porous polyethylene [Medpor]). Median follow-up duration in this study was 37.6 months. Implant exposure occurred in 1 of the 68 nonporous implant cases (1.5%) and in 4 of the 190 porous implant cases (2.1%). This difference is not statistically significant (P = 0.85). In contrast, clinically significant implant migration occurred substantially more frequently in the patients who received a nonporous implant. The cumulative actuarial probability of implant migration at 60 months was 15.5% for the nonporous implants versus 0.7% for the porous implants. This difference was statistically significant (P = 0.0003).


CONCLUSIONS
Orbital implant migration occurred in a significantly greater proportion of patients who received a nonporous implant than in those who received a porous implant. Implant exposure occurred at a low rate that was not significantly different in the two subgroups.
Trichopoulos
Nikolaos
N
Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA.
Augsburger
James J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017886:Durapatite; D015353:Eye Enucleation; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D020273:Orbital Implants / Q000009:adverse effects*; D011095:Polyethylenes; D019904:Polymethyl Methacrylate; D016062:Porosity; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology*
C084562:Medpor; D011095:Polyethylenes; D019904:Polymethyl Methacrylate; D017886:Durapatite