title: Orbital implants: potential new directions.
abstract: This article reviews orbital implants used to replace an eye after enucleation or evisceration. Advantages of implant placement are described, with discussion of implant and wrap material, and design features that affect clinical outcomes. Implants may be porous or nonporous, pegged for linkage with a cosmetic shell or unpegged, and may be wrapped with a covering material or tissue or unwrapped. Device shape, volume and material qualities affect tissue tolerance and the risk of exposure or extrusion. Limitations of currently available devices are discussed, with factors affecting surgeon and patient choice. Ideally, a device should be easy to insert, avoid the need for wrapping or adjunctive tissues, be light, biointegratable, comfortable after implantation and provide satisfactory orbital volume replacement, movement and cosmesis without requiring further surgery or pegging. This review briefly discusses developments in implant design and aspects of design that affect function, but is not a detailed clinical review; rather, it aims to stimulate thought on optimal design and discusses recent developments. Novel technology in the form of a prototype device with a soft, biointegratable anterior surface is described as an example of newer approaches.
authors.affiliation: Department Biomaterials and Polymer Research, Lions Eye Institute, and Research Ophthalmologist, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Australia. crhicks@cyllene.uwa.edu.au
authors.forename: Celia R
authors.initials: CR
authors.lastname: Hicks
authors.forename: David
authors.initials: D
authors.lastname: Morrison
authors.forename: Xia
authors.initials: X
authors.lastname: Lou
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Crawford
authors.forename: Adam
authors.initials: A
authors.lastname: Gadjatsy
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Constable
mesh_terms: D015353:Eye Enucleation / Q000295:instrumentation*; D017234:Eye Evisceration / Q000295:instrumentation*; D006801:Humans; D020273:Orbital Implants; D016062:Porosity; D011183:Postoperative Complications / Q000209:etiology; D011474:Prosthesis Design