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KMID : 0213520190330030267
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Korean Journal of Ophthalmology
2019 Volume.33 No. 3 p.267 ~ p.271
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Treatment of Exposed Hydroxyapatite Orbital Implants Wrapped with a Synthetic Dura Substitute
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Shin Woo-Beom
Ko Jae-Sang
Yoon Jin-Sook
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Abstract
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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.
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KEYWORD
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Hydroxyapatite orbital implant, Neuro-Patch, Orbital implant exposure, Wrapping material
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