Porous orbital implants, wraps, and PEG placement in the pediatric population after enucleation.
OBJECTIVE
To investigate complications of various porous orbital implants and wrapping materials in the pediatric population after enucleation.


METHODS
A retrospective, comparative, nonrandomized study.


METHODS
Between November 1992 and November 2006, patients younger than 15 years old were collected for study participation. They underwent enucleation with porous orbital implants primarily or secondarily at National Taiwan University Hospital. The authors used the hydroxyapatite (HA), Medpor, and Bioceramic orbital implant. The HA implant was wrapped with four different materials: donor sclera, Lyodura, porcine sclera, and Vicryl mesh. A part of HA implants and all bioceramic implants were wrapped with Vicryl mesh, added anteriorly with scleral patch grafts. All Medpor implants were unwrapped.


RESULTS
Forty-seven cases had more than a two-year follow-up. The exposure rates according to implants and wraps were: donor sclera-wrapped HA (two of nine, 22%), porcine sclera-wrapped HA (three of three, 100%), Vicryl mesh-wrapped HA (one of five, 20%), and unwrapped Medpor (one of four, 25%). No exposure was found in four Lyodura-wrapped HA implants, and 22 Vicryl mesh-wrapped HA and Bioceramic implants with anteriorly scleral coating. The exposure rate was lower in cases with implants wrapped by our method and Lyodura than in those with implants wrapped by other materials (P < .001). Of 47 patients, 20 (42.5%) were fitted with peg-coupled prostheses and all had good prosthetic movements subjectively.


CONCLUSIONS
Different types of implants and wraps resulted in various exposure rates in the pediatric population. The modified wrapping technique may prevent porous implants from exposure in children.
Wang
Jia-Kang
JK
Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan.
Liao
Shu Lang
SL
Lin
Luke L K
LL
Kao
Shine C S
SC
Tseng
Hsiao-Sen
HS
D000293:Adolescent; D000537:Aluminum Oxide; D002648:Child; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible; D003094:Collagen; D017886:Durapatite; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009915:Orbit / Q000601:surgery*; D020273:Orbital Implants; D011095:Polyethylenes; D011098:Polyglactin 910; D016062:Porosity; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D012590:Sclera; D053831:Surgical Fixation Devices
D020099:Coated Materials, Biocompatible; C032281:Lyodura; C084562:Medpor; D011095:Polyethylenes; D011098:Polyglactin 910; D003094:Collagen; D017886:Durapatite; D000537:Aluminum Oxide