Outcome of porous implants: Incidence of complications, management, and morbidity

Chalao Pongprayoon MD*

Affiliation : * Department of Ophthalmology, Priest Hospital

Objective : To determine the incidence of complications and the outcome associated with the use of three kinds of ocular porous implants. Material and Method : Retrospective review of 133 consecutive case series. All patients undergoing orbital implantation either primary or secondary implantation of 49 coral hydroxyapatite, 43 human bone hydroxyapatite and 39 bovine bone hydroxyapatite from September 1995 to September 2007 were included. Charts were reviewed for preoperative diagnoses, type and size of implant, use of a wrapping material, and complications. Patients were followed for signs of inflammation, infection, extrusion, or other complications. Results : There are more exposures of human bone hydroxyapatite (8.16%) and bovine bone hydroxyapatite (7.69%) than coralline hydroxyapatite implants (2.22%). Spontaneous healing of exposures occurred in 25% (2 of 8) of cases. Covering exposures with patch grafts underneath vascularized conjunctival flaps was the most successful method of surgical repair in 2 cases (25%). Chronic infection of the 2 exposed human bone hydroxyapatite leading to the removal of the 2 implants (1.5%) . Conjunctival granulomas and late exposure developed in 2 and 3 patients after peg coupling respectively. There were no cases of implant migration or prolonged inflammation related to the covering material. Conclusion : Careful selection of surgical technique, implant type and size may help reduce the risk of severe complications.

Keywords : Orbital implantation, coral hydroxyapatite, human bone hydroxyapatite, bovine bone hydroxya- patite, extrusion of hydroxyapatite, exposure of hydroxyapatite, patch grafts, peg coupling

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