Management of Exposed Porous Orbital Implants.

Sun, Duck Young; Kim, Yoon Duck

Original Article

Journal of the Korean Ophthalmological Society 2004;45(9):1409-1419.
Published online September 1, 2004.

Management of Exposed Porous Orbital Implants.

¹Department of Ophthalmology, Kyunghee University, College of Medicine, Seoul, Korea.
²Department of Ophthalmology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea. ydkim@smc.samsung.co.kr

노출된 다공성 안와삽입물의 치료

선덕영 ( Duck Young Sun ) , 김윤덕 ( Yoon Duck Kim )

Abstract

PURPOSE
With its increasing popularity, several complications, such as infection, exposure, and extrusion have been reported in the use of the porous orbital implants. Exposure of the implants is one of the most difficult complications to treat. We evaluate the effect of treatment in exposed porous orbital implants with various techniques. METHODS: From January 1995 to December 2000, 15 patients visited our clinic with exposure of implant after porous orbital implantation. The following procedures were used to cover the implants: observation with delayed prosthesis fitting and posterior vaulting of the prosthesis, burring away the anterior surface of the hydroxyapatite implant and placing dermis fat graft, removing infected implants and dermis fat graft, and removal and 180degrees rotation and replacement of porous implants according to the degree of exposure. RESULTS: Porous implants exposures occurred 1 to 12 weeks after implantations (mean, 5.2 weeks). Small areas of exposure (<3mm) closed spontaneously (2 cases), remained stationary (2 cases), and increased the exposure area requiring dermis fat graft (1 case). During the follow-up period (mean, 19 months), no porous orbital implant was exposed again except 1 case who received previous orbital irradiation therapy. CONCLUSIONS: Small exposure of porous orbital implants less than 3 mm in diameter may be closed with nonsurgical methods. In the case of exposure larger than 4 mm, dermis fat graft or removal and 180degrees rotation and replacement of porous implants were effective in the treatment of exposure.

Key Words: Dermis fat graft;Exposed porous orbital implants;Treatment