title: Repair of exposed hydroxyapatite orbital implants by subconjunctival tissue flaps.
abstract: OBJECTIVE
  The purpose of the study was to determine the feasibility of the use of subconjunctival tissue flaps to repair exposed hydroxyapatite (HA) orbital implants.
  
  
  METHODS
  One hundred thirty-eight consecutive patients underwent repair of exposed HA orbital implants via a procedure that involved the creation of subconjunctival tissue flaps. After the superior and inferior subconjunctival flaps were created, they were sutured together in the tension-free state to seal the exposure. During follow-up examinations, complications were assessed.
  
  
  RESULTS
  Twelve patients were lost after the 3-month follow-up, leaving 126 patients who were followed from 12 to 60 months (average, 24 months). Problems occurred in 22 patients (17.5%), including recurrence of exposure in 4 patients (3.2%), ptosis in 12 patients (9.5%), pyogenic granulomas in 1 patient (0.8%), a conjunctival cyst in 1 patient (0.8%), implant infection in 1 patient (0.8%), and poor transfer of movement in 3 patients (2.4%).
  
  
  CONCLUSIONS
  The use of the subconjunctival tissue flaps for repairing exposed HA orbital implants is a promising alternative for the management of implant exposure. Although this novel technique is associated with some complications, these problems can be minimized by careful case selection and careful surgery.
authors.affiliation: Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Linna
authors.initials: L
authors.lastname: Lu
authors.forename: Wodong
authors.initials: W
authors.lastname: Shi
authors.forename: Min
authors.initials: M
authors.lastname: Luo
authors.forename: Ying
authors.initials: Y
authors.lastname: Sun
authors.forename: Xianqun
authors.initials: X
authors.lastname: Fan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000601:surgery; D003229:Conjunctival Diseases / Q000209:etiology; D003560:Cysts / Q000209:etiology; D017886:Durapatite; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D017789:Granuloma, Pyogenic / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000209:etiology; D020273:Orbital Implants; D011183:Postoperative Complications; D011391:Prolapse; D016459:Prosthesis-Related Infections / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000145:classification*; D013529:Surgical Wound Dehiscence / Q000601:surgery*; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite