Porous polyethylene (Medpor) orbital implants with primary acellular dermis patch grafts.
OBJECTIVE
To evaluate the results of the porous polyethylene (Medpor) orbital implantation technique combined with the use of a primary patch graft of acellular dermis.


METHODS
The study design was a retrospective, non-comparative single surgeon case series of 27 patients. The Medpor orbital implant was placed with a primary anterior sub-Tenon's acellular dermis patch after evisceration (23/27), enucleation (2/27) or implant exchange/secondary implant procedure (2/27) over a period of 3 years. Risk factors for dehiscence/complications were defined as trauma, infection, inflammation, previous ocular surgery, radiotherapy, secondary orbital implantation, and removal of extruding implants. The primary outcome measure was the development of implant exposure. Other complications were also recorded, including postoperative conjunctival wound dehiscence.


RESULTS
Twenty-five patients (93%) had more than 2 risk factors. Mean follow-up time was 22 months (median 24 months, range 4-34 months). Three (11%) patients needed further intervention, which included pyogenic granuloma excision (1) and fornix formation (1). Conjunctival wound dehiscence followed by implant exposure occurred in 1 of 27 eyes (3.7%). The cosmetic appearance was satisfactory in 26/27 patients.


CONCLUSIONS
Our results with primary acellular dermis grafts when coupled with Medpor orbital implantation are encouraging.
Kadyan
Anju
A
Wolverhampton and Midland Counties Eye Infirmary, Wolverhampton, West Midlands, UK.
Sandramouli
Soupramanien
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D017233:Orbit Evisceration; D020273:Orbital Implants; D011095:Polyethylenes / Q000627:therapeutic use*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies
C440568:Alloderm; D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes; D003094:Collagen