A Long-Term Follow-Up Study of Scleral Grafting for Exposed or Extruded Orbital Implants

Surgical coverage of exposed hydroxyapatite implant with retroauricular myoperiosteal graft

“…However, with increasing use of hydroxyapatite implant, complications such as tissue breakdown, conjunctival dehiscence, and implant exposure are becoming more apparent to oculoplastic surgeons. [4][5][6][7][8][9][10][11][12][13] Several causes of hydroxyapatite implant exposure had been proposed, including using too large an implant, tension on the wound, excessive inflammation related to hydroxyapatite material itself, 7 18 spicules on the hydroxyapatite implant surface, 19 pressure from the prosthesis to the conjunctival surface, 5 or inadequate vascularisation of the implant. 6 They can be prevented by appropriate surgical technique and implant size, covering the implant with the wrapped materials, attempting to accelerate vascularisation and vaulting of the prosthesis.…”

“…1 4-7 The need to deal with this complication has become obvious to oculoplastic surgeons. 5 Many patch graft materials, such as banked sclera, [8][9][10][11][12] dermis fat grafts, 5 hard plate mucosa, and temporalis fascia and fascia lata 13 have been proposed with variable results. Poor vascularisation and graft melting were frequently seen in cases where such graft materials were used.…”

The Effect of Autologous Serum Eye Drops on the Conjunctivalization over Exposed Porous Polyethylene Orbital Implant (Medpor®) in the Rabbit Model

“…However, recurrent exposures and graft melting may occur if vascular supply is insufficient (Helveston, 1969;Fountain and Helveston, 1982;Liao et al, 2005). Thus, rapid healing with a well-vascularized conjunctival flap can reduce the possibility of infection, graft melting and shorten the time interval for prosthesis fitting that may consequently accelerate the rehabilitation of patients.…”

Remove, rotate, and reimplant: a novel technique for the management of exposed porous anophthalmic implants in eviscerated patients

“…20 Exogenous scleral patch grafts carry the risk of transmission of slow virus infections. 27,28 Liao et al 3 concluded that banked sclera may melt if vascular supply was insufficient and it might contain infectious agents. Also as a homologous material, it may generate more inflammation than autologous tissue.…”