title: Management of porous orbital implants requiring explantation: a clinical and histopathological study.
abstract: OBJECTIVE
  To perform a histopathological review of exposed porous orbital implants requiring explantation and to study the clinical outcome of replacement of the exposed implant with an autologous dermis-fat graft.
  
  
  METHODS
  Case series. Analysis of the clinical charts of 25 patients (age 5 to 62 years) who were submitted to explantation of exposed hydroxyapatite orbital implants, followed by simultaneous replacement with a dermis-fat graft by 1 oculoplastic surgeon between 2000 and 2011. A histopathological and microbiological evaluation of implant sections was performed. This study adheres to the principles outlined in the Declaration of Helsinki.
  
  
  RESULTS
  Microbiological examination showed the presence of Gram-positive cocci infection in 59% of the patients. Histopathological examination showed the presence of a chronic inflammatory infiltrate in 22 of the implants (88%) and significantly reduced fibrovascular colonization of the implant in all patients.
  
  
  CONCLUSIONS
  The reduction of fibrovascular ingrowth resulted in poor integration of the implant in the eye socket. The exposure allowed bacterial colonization of the implant, causing a chronic inflammatory infiltrate. A dermis-fat graft at the same time of explantation can be considered a suitable surgical option in both adults and children: only minor complications may occur, and cosmetic results are satisfactory.
authors.affiliation: *Orbital and Adnexal Service, Department of Ophthalmology, †Department of Pathology, Villa Tiberia Hospital, Via Emilio Praga;and ‡Department of Ophthalmology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, Roma, Italy.
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Quaranta-Leoni
authors.forename: Caterina
authors.initials: C
authors.lastname: Moretti
authors.forename: Sabrina
authors.initials: S
authors.lastname: Sposato
authors.forename: Stefano
authors.initials: S
authors.lastname: Nardoni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lambiase
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonini
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D017886:Durapatite; D017234:Eye Evisceration; D005137:Eye, Artificial; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000382:microbiology / Q000601:surgery*; D020273:Orbital Implants; D016062:Porosity; D012086:Reoperation; D012189:Retrospective Studies; D050151:Subcutaneous Fat / Q000637:transplantation*; D013529:Surgical Wound Dehiscence / Q000382:microbiology / Q000601:surgery*; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D017886:Durapatite