Clinical analysis of hydroxyapatite orbital implantation after ocular trauma in 211 cases.
OBJECTIVE
To evaluate the therapeutic effects and complications of hydroxyapatite (HA) orbital implantation on patients after trauma-related surgeries.


METHODS
Retrospective analysis was made from 211 cases (211 eyes) who underwent HA orbital implant placement after trauma-related enucleation or evisceration, including 68 cases of evisceration and primary HA implant placement, 77 cases of enucleation and HA implant placement wrapped with multi-windowed sclera, 66 cases of enucleation and HA implant placement free of wrapping. All the cases were followed up for 1-5 years to observe the therapeutic effects and major complications.


RESULTS
Five of 211 cases had wound dehiscence. Ten cases had HA implants exposure, including 1 case suffering severe orbital infection and requiring HA implant removal. The implants exposure incidences by the three surgical methods were from 1.30% to 10.06% and averaged 4.74%. Significant difference was found in late exposure incidence and total incidence from the three methods (chi(2)=13.372, P < 0.01 and chi(2)=7.540, P < 0.05). Two cases had shrinkage of the lower fornix. Enophthalmos occurred in 1 case treated by method 1 and was corrected by implanting porous polyethylene (Medpor) plate into the bottom of orbit. In 210 cases, the artificial eye moved well and the cosmetic results were satisfactory.


CONCLUSIONS
Different surgical methods have their own merit and disadvantage. Enucleation and placement of HA implant wrapped with multi-windowed sclera has corroborated fewer complications than others.
Liang
Tao
T
Department of Ophthalmology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, China.
Zhao
Gui-qiu
GQ
Meng
Xu-xia
XX
Zhang
Ling-yun
LY
D000328:Adult; D017886:Durapatite; D015353:Eye Enucleation / Q000379:methods; D017234:Eye Evisceration / Q000379:methods; D015807:Eye Injuries, Penetrating / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D020273:Orbital Implants; D019919:Prosthesis Implantation / Q000379:methods; D012189:Retrospective Studies
D017886:Durapatite