Ocular implants-methods of ocular reconstruction following radical surgical interventions

Abstract

The main motivation of an ocular-orbital reconstruction after a radical surgical intervention (evisceration, enucleation) is represented by the psychological and socio-economic impact of such interventions on life conditions of patients. The current methods for ocular prosthesis are based on a new concept, which is nanotechnology, and its main objectives represent the reconstruction of the remaining orbital volume, reduction of postoperative complications and maintaining a satisfactory esthetical aspect.This review will discuss the numerous types of ocular implants that have been used throughout history as well as the most recent methods used by ophthalmic surgeons, also taking into consideration the advantages and disadvantages from a cosmetic, functional and short and long term postoperative complications point of view.

Biological activity of a vascular endothelial cell‑hydroxyapatite orbital implant complex: An experimental study

“…It was documented that infection occurred in 5.19% in a series of 212 patients with HA implants over a period of 12 years (42). Catalu et al (43) reported that radical surgery (evisceration or enucleation) can reduce the occurrence of ocular infections. Thus, we investigated the biological activity of a vascular endothelial cell-hydroxyapatite orbital implant complex intraoperatively, which can promote and improve the clinical treatment of orbital implantation.…”

The effects of hydroxyapatite implantation with the autogenous sclera cap: A cohort study

“…[3] Because of the different etiologies, the main methods of eye removal surgery include evisceration, enucleation and exenteration. [2] At present, there are several kinds of operation methods for implanting artificial eyes after evisceration of eye contents, including buried, exposed-integrated, and buried-integrated implants. [2] In traditional scleral implantation, after evisceration of eye contents, the optic nerve is cut or not cut, and then the incision is extended backward along the front of the scleral shell; the HA artificial eye is directly implanted into the scleral shell, and then the anterior sclera is tightened and sutured.…”

“…In 1885, Nuless first implanted a glass ball into the conjunctiva sac, [ 1 ] and in 1985, Perry began implanting hydroxyapatite (HA) orbital implants to increase the beauty effect. [ 2 ] HA has the same mineral composition as human bone tissue, good biocompatibility, light weight, no absorption, and little stimulation to surrounding tissues. HA is a novel orbital implant material that has been widely used in recent years and is conducive to the ingrowth of orbital fiber vessels.…”

“…[ 2 ] At present, there are several kinds of operation methods for implanting artificial eyes after evisceration of eye contents, including buried, exposed-integrated, and buried-integrated implants. [ 2 ] In traditional scleral implantation, after evisceration of eye contents, the optic nerve is cut or not cut, and then the incision is extended backward along the front of the scleral shell; the HA artificial eye is directly implanted into the scleral shell, and then the anterior sclera is tightened and sutured. However, the anterior sclera is not easy to suture, and there could be some exposure of part of the front of the HA implant.…”

“…HA is a novel orbital implant material that has been widely used in recent years and is conducive to the ingrowth of orbital fiber vessels. [2] Complications of HA implants mainly include infection, implant exposure, conjunctival thinning, implant extrusion, conjunctival dehiscence, pyogenic granuloma formation and persistent implantation, among which implant exposure is the most common, with an incidence of approximately 2.5% to 21.6%, and infection is the most serious complication. [3] Because of the different etiologies, the main methods of eye removal surgery include evisceration, enucleation and exenteration.…”