Treatment of Exposed Hydroxyapatite Orbital Implants Wrapped with a Synthetic Dura Substitute
- Author:
Woo Beom SHIN
1
;
Jaesang KO
;
Jin Sook YOON
Author Information
- Publication Type:Original Article
- Keywords: Hydroxyapatite orbital implant; Neuro-Patch; Orbital implant exposure; Wrapping material
- MeSH: Anesthesia, Local; Conjunctiva; Durapatite; Humans; Inflammation; Lidocaine; Medical Records; Orbit; Orbital Implants; Surgical Instruments
- From:Korean Journal of Ophthalmology 2019;33(3):267-271
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To describe cases of exposed hydroxyapatite (HA) implants wrapped with the synthetic dura substitute Neuro-Patch treated via simple Neuro-Patch removal. METHODS: The medical records of seven patients who experienced exposure of their HA implant were reviewed. All patients had been enucleated and implanted with HA wrapped with Neuro-Patch. For treatment, Neuro-Patch was removed to the greatest extent possible. After applying local anesthesia with lidocaine, blunt dissection was performed to separate the conjunctiva and Neuro-Patch via the site of exposure. Pressure was applied to the remaining Neuro-Patch with forceps and removed with scissors. RESULTS: Neuro-Patch was visible at the area of exposure in all patients. No surgery beyond initial Neuro-Patch removal was necessary in six of the seven patients. In five cases, the exposed area began to heal rapidly after Neuro-patch removal without primary closure of the defect. In one case, the Neuro-Patch material and all necrotic tissue was removed aggressively due to inflammation around the orbital implant. Lastly, an infection was noted in one case, prompting complete removal of the Neuro-Patch–wrapped HA implant. CONCLUSIONS: Wrapping material may hinder implant vascularization. Exposure of HA in wrapped implants can be successfully treated by a simple removal procedure if detected and managed early.
