Prevention of exposure of porous orbital implants following enucleation.
OBJECTIVE
To investigate effectiveness of adding a scleral patch graft on a Vicryl mesh-wrapped porous orbital implant to prevent exposure following enucleation.


METHODS
A retrospective, comparative, nonrandomized study.


METHODS
From October 1996 to February 2006, 74 consecutive patients (74 sockets) who received porous orbital implants primarily or secondarily after enucleation at National Taiwan University Hospital (72 cases) and at Far Eastern Memorial Hospital (2 cases) were collected. Patient demographics, ocular diagnosis, the surgical technique, prior ophthalmic surgery, type, covering, and size of the implant, follow-up periods, and complications associated with pegs and implants were recorded. Group 1 patients received a Vicryl mesh-wrapped implant without a scleral patch graft. Group 2 patients received anterior capping with a scleral patch on the Vicryl mesh-wrapped implant.


RESULTS
Of 74 identified cases, 12 were excluded for insufficient follow-up. The 62 remaining cases had more than a two-year follow-up. There were two implant exposures (12%, two of 17) in group 1. Retroauricular myoperiosteal graft and scleral patch were used to repair exposed implants successfully. No exposure was noted in group 2 (n = 45). A significant between-group difference in exposure rate was found (P = .02). Early conjunctival dehiscence followed by spontaneous healing occurred in three group 2 patients.


CONCLUSIONS
Scleral patch graft and Vicryl mesh can act as duplicate barriers between anterior surface of implants and overlying soft tissue. The modified wrapping technique prevents porous implants from exposure effectively.
Wang
Jia-Kang
JK
Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan.
Liao
Shu-Lang
SL
Lai
Pei-Ching
PC
Lin
Luke L K
LL
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible; D015353:Eye Enucleation; D005260:Female; D005548:Foreign-Body Migration / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D020273:Orbital Implants; D011098:Polyglactin 910; D016062:Porosity; D012189:Retrospective Studies; D012590:Sclera / Q000637:transplantation*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*
D020099:Coated Materials, Biocompatible; D011098:Polyglactin 910