Exposure rate of unwrapped hydroxyapatite orbital implants in enucleation surgery

Abstract

The placement of an unwrapped HA orbital implant with rectus end-to-end suturing in enucleation surgery was associated with a low rate of exposure in most cases. The end-to-end suturing creates a joint-like structure over the HA sphere, protecting the Tenon's capsule and conjunctiva from its rough surface and reducing the risk of implant exposure. Prior ocular surgery may be another risk factor for HA exposure.

An accurate interactive segmentation and volume calculation of orbital soft tissue for orbital reconstruction after enucleation

“…This measurement accuracy can helpful to achieve an accurate clinical evaluation. In our previous study, we investigated the implant size and exposure rate of 234 cases who went through two different surgical techniques for enucleation: the rectus endto-end suturing procedure and the rectus orthotopic suturing procedure [28]. In this study, on the basis of having validated the accuracy of orbital soft tissue segmentation by graph cut method, we further applied it to the reconstruction and evaluation of clinical complex orbital conditions after ocular enucleation with the above procedures.…”

“…Ten adult patients who underwent enucleation and orbital prosthesis implantation took the orbital CT exanmination three months after surgery. As we reported previously, there were two closure methods used for hydroxyapatite (HA) sphere prosthesis implantation [28]. Of these patients, five underwent rectus end-to-end suturing procedure, and five underwent rectus orthotopic suturing procedure.…”

Orbital implant exposure following enucleation or evisceration

“…In end-to-end suturing closure, the rectus muscles were drawn over the anterior surface of the implant and sutured end to end forming a joint-like structure crossing over the anterior part of the implant and acting as an interface between the implant and two layers of tissue, thus avoiding the risk of immune reaction and inflammation. [5] All patients included in our study had rectus end-to-end suturing closure technique.…”

Learning from Nature: Using bioinspired approaches and natural materials to make porous bioceramics

“…Furthermore, problems of mechanical integrity upon implantation or during the postoperative follow‐up were reported in some cases due to the inherent brittleness of the implants especially if characterized by a high pore content (above 80 vol%) . Primarily in order to reduce the cost of the device, synthetic porous hydroxyapatite has gained increasing popularity as a less expensive surgical option with analog clinical performances …”

“…36 Primarily in order to reduce the cost of the device, synthetic porous hydroxyapatite has gained increasing popularity as a less expensive surgical option with analog clinical performances. 42,43 Over the years the replamineform process was also applied to other marine CaCO 3 sources apart from corals including cuttlefish bone, 44 sea urchin spine, 45 and mineralized algae. 46 The latest evolution of this process was recently reported by Jones et al, 47 who produced bone-like hydroxyapatite from waste mussel shells.…”