Hydroxyapatite Orbital Implant After Enucleation Experience With Initial 100 Consecutive Cases

Shields, Carol L.

doi:10.1001/archopht.1992.01080150031022

Cited by 150 publications

(36 citation statements)

References 16 publications

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“…9 Sclera, which has been the most commonly used wrapping material, has a wound dehiscence rate of 1-33%. 10,11 Dehiscence rates of 5-23% with the use of bovine pericardium wraps (Ocuguard s ) have also been reported. 7,9,12 There are no published studies on the use of Tutopatch s as a wrapping material, but lack of our complications in our pilot study compares favourably to published studies with the other wrapping materials.…”

Section: Discussionmentioning

confidence: 99%

Bovine pericardium (Tutopatch) wrap for hydroxyapatite implants

Gupta

Lyon

Singh

et al. 2006

Eye

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Purpose To evaluate bovine pericardium (Tutopatch s ) as a wrapping material for hydroxyapatite implants in patients undergoing enucleation for uveal melanoma. Method Prospective cohort study of patients who had enucleation for uveal melanoma between January 2003 and August 2003 were included in the study. Any patient with less than 3 months follow-up was excluded. Enucleation was performed under general anaesthesia followed by insertion of hydroxyapatite implants wrapped in bovine pericardium (Tutopatch). The recti muscles were sutured directly to the wrap. The tenon's capsule and conjunctiva were closed in two layers. A conformer was inserted at 1 week and artificial eye at 2-3 months. The patients were followed up regularly and were assessed for cosmetic result, exposure of implant, and the need for any further surgical procedures. Results A total of 19 patients (seven male and 12 female) were included in the study. Median age at diagnosis was 63 years (range 38-80 years). Median follow-up was 26 months (range 22-30 months). No patient developed postoperative complications of wound dehiscence. The overall cosmetic result was excellent in all the patients. The rate of postoperative complications compared favourably with published data using other wrapping materials/implants. Conclusion Tutopatch s is a safe wrapping material for hydroxyapatite orbital implants in patients undergoing enucleation for uveal melanoma.

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Section: Discussionmentioning

confidence: 99%

Bovine pericardium (Tutopatch) wrap for hydroxyapatite implants

Gupta

Lyon

Singh

et al. 2006

Eye

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“…1,2,4,10-12 The benefit of using this implant is its extensive porous system permitting fibrovascular ingrowths, which decreases the risk of implant extrusion and infection. 2,13,14 In addition, with drilling and peg insertion, this implant can be directly coupled to the prosthesis, allowing a wide range of prosthetic movement, especially fine darting eye movements commonly seen during conversational speech. 5 These movements impart a more lifelike quality to the prosthetic eye.…”

Section: Discussionmentioning

confidence: 99%

Primary Placement of a Titanium Sleeve in Hydroxyapatite Orbital Implants

Liao

Chen

Lin

2004

Eye

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Background: To study a new surgical option of primary placement of a titanium sleeve into hydroxyapatite implants during enucleation or evisceration. Methods: A standard enucleation or cornea preserved evisceration was performed, followed by preplacement of a titanium sleeve into the hydroxyapatite implant by a hand drill sleeve driver. Care must be taken to ensure that the titanium sleeve is positioned centrally when the implant is put inside the orbital socket or eviscerated shell. The Tenon capsule and conjunctiva were meticulously closed with minimal tension. Complications such as sleeve exposure, coralline exposure, and infection of the titanium sleeve were closely observed. Results: In all, 30 patients were treated in the above fashion with 10 enucleation and 20 evisceration procedures. The follow-up period ranged from 9 to 24 months. Three of the sleeves were found to have exposed spontaneously at 5 and 7 weeks following original surgery. They had no further complication except one sleeve loosening. The remaining 27 sleeves that did not spontaneously expose pursued secondary exposure of the titanium sleeve and peg insertion by conjunctival cutdown procedure 3 months after original surgery. Two sleeves were found to be oblique positioned after the conjunctival cutdown procedure. Fortunately, all the 30 patients were successfully fit with a peg-coupled prosthesis with good motility. Conclusion: Primary placement of a titanium sleeve into hydroxyapatite implants has several advantages, including high patient acceptance, technical simplicity, and officebased conjunctival cutdown pegging procedure. By avoiding the expense of postoperative imaging study and additional

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“…When the porous hydroxyapatite implant is implanted in the orbit following an enucleation or an evisceration, it becomes completely ingrown and integrated with the fibrovascular tissues of the orbit [6,10]. This fibrovascularization supports epithelial growth along the sides of the hole drilled for the motility peg of the prosthesis and resists migration and extrusion prosthesis [2,11].…”

Section: Discussionmentioning

confidence: 99%

Osseous metaplasia with functioning bone marrow in hydroxyapatite orbital implants

Lew

Shin

Lee

et al. 2000

Graefe's Archive for Clinical and Experimental Ophthalmology

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Background: Bone formation within the hydroxyapatite implant has been reported in explanted spheres in humans. Bone-specific differentiation was observed to occur earlier in the pores of spherical hydroxyapatite implants enhanced with osteogenin within the rabbit socket. We observed previously unreported bone marrow formation in a coralline hydroxyapatite implant placed into the rabbit orbit after evisceration. Methods: One eye of each of 10 New Zealand white rabbits weighing between 2 and 3 kg was eviscerated and implanted with hydroxyapatite spheres. The explanted hydroxyapatite spheres 20 weeks after surgery were examined under the microscope. Results: Histopathologic examination of the excised implants showed the presence of trabeculae of mature bone with fatty marrow and hematopoietic elements. Scattered throughout the fatty tissue were bone marrow elements consisting of precursors of the granulocytic and erythroid series and also megakaryocytes. Conclusion: The osseous metaplasia with functioning bone marrow was incidentally observed in the coralline hydroxyapatite implant without the addition of any osteogenesis-inducing agents.

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Hydroxyapatite Orbital Implant After Enucleation Experience With Initial 100 Consecutive Cases

Cited by 150 publications

References 16 publications

Bovine pericardium (Tutopatch) wrap for hydroxyapatite implants

Bovine pericardium (Tutopatch) wrap for hydroxyapatite implants

Primary Placement of a Titanium Sleeve in Hydroxyapatite Orbital Implants

Osseous metaplasia with functioning bone marrow in hydroxyapatite orbital implants

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