Evaluation of efficacy and complications: primary pediatric orbital implants after enucleation.

BACKGROUND Orbital implants are used routinely in pediatric patients at the time of enucleation. Complications, such as exposure, ptosis, and infection, may occur after implantation. Controversy continues regarding the rate of complications with newer implants in the pediatric population. OBJECTIVE To examine the effects of orbital implants on children whose eyes have been enucleated. METHODS Records of orbital implantation after enucleation performed by 5 surgeons on 120 pediatric patients (123 eyes) over a 10.5-year period were reviewed retrospectively. Demographic data, ocular diagnosis, prior ophthalmic surgery, implant characteristics, and postoperative complications were described using a standardized format for all patients, with a minimum of 6 months of follow-up (mean, 3 years). RESULTS Complications were observed in 7 eyes (5.7%). Implant exposure (1 [0.8%]), implant extrusion (0 [0%), and implant migration (3 [2.4%) were rare. One hundred eighteen eyes (96%) had good cosmesis and 120 (98%) had good motility. CONCLUSIONS Orbital implantation after enucleation is successful in the pediatric population. Complications are minimal. Hydroxyapatite implants were not associated with unacceptable complications in this pediatric population.

[1]  L. Mawn,et al.  Complications associated with pegging hydroxyapatite orbital implants. , 1999, Ophthalmology.

[2]  K. Trinkaus,et al.  Comparative motility of hydroxyapatite and alloplastic enucleation implants. , 1999, Ophthalmology.

[3]  M W Wilson,et al.  Infection of a Porous Polyethylene Orbital Implant With Capnocytophaga , 1998, Ophthalmic plastic and reconstructive surgery.

[4]  J. O'Brien,et al.  Intraorbital implants after enucleation and their complications: a 10-year review. , 1998, Archives of ophthalmology.

[5]  L. Mawn,et al.  The Synthetic Hydroxyapatite Implant: A Report on 65 Patients , 1998, Ophthalmic plastic and reconstructive surgery.

[6]  P. Mullaney,et al.  Porous polyethylene orbital implant in patients with retinoblastoma. , 1998, Ophthalmology.

[7]  P. Rubin,et al.  Enhancement of the cosmetic and functional outcome of enucleation with the conical orbital implant. , 1998, Ophthalmology.

[8]  J. Katowitz,et al.  Unilateral Dermis‐Fat Graft Implantation in the Pediatric Orbit , 1998, Ophthalmic plastic and reconstructive surgery.

[9]  P. Mullaney,et al.  Extrusion of porous polyethylene orbital implant in recurrent retinoblastoma. , 1998, Ophthalmic plastic and reconstructive surgery.

[10]  J. Holds,et al.  Difficulties with Hydroxyapatite Orbital Implants in Two Patients with Dysfunctional Levator/Superior Rectus Muscle Complex , 1997, Ophthalmic plastic and reconstructive surgery.

[11]  C. Shields,et al.  Complications of motility peg placement for the hydroxyapatite orbital implant. , 1997, Ophthalmology.

[12]  J. Oestreicher,et al.  Complications of hydroxyapatite orbital implants. A review of 100 consecutive cases and a comparison of Dexon mesh (polyglycolic acid) with scleral wrapping. , 1997, Ophthalmology.

[13]  J. Ashworth,et al.  The hydroxyapatite orbital implant: A prospective study , 1996, Eye.

[14]  J. Linberg,et al.  Evisceration with hydroxyapatite implant. Surgical technique and review of 31 case reports. , 1995, Ophthalmology.

[15]  M. Sherif,et al.  Management of Tissue Breakdown and Exposure Associated with Orbital Hydroxyapatite Implants , 1995, Ophthalmic plastic and reconstructive surgery.

[16]  A. McNab Hydroxyapatite orbital implants. Experience with 100 cases. , 1995, Australian and New Zealand journal of ophthalmology.

[17]  K. V. Jahrling,et al.  Complications of porous spherical orbital implants. , 1995, Ophthalmology.

[18]  P. Finger,et al.  Use of the hydroxyapatite ocular implant in the pediatric population. , 1995, Archives of ophthalmology.

[19]  M. Mazow,et al.  Use of the hydroxyapatite ocular implant in the pediatric population. , 1995, Archives of ophthalmology.

[20]  Ashutosh Kumar Singh,et al.  Problems with the hydroxyapatite orbital implant: experience with 250 consecutive cases. , 1994, The British journal of ophthalmology.

[21]  J. Kwartz,et al.  The ‘baseball’ orbital implant: A prospective study , 1994, Eye.

[22]  C. Shields,et al.  Hydroxyapatite Orbital Implant After Enucleation for Intraocular Tumors , 1993, International ophthalmology clinics.

[23]  Ashutosh Kumar Singh,et al.  Lack of complications of the hydroxyapatite orbital implant in 250 consecutive cases. , 1993, Transactions of the American Ophthalmological Society.

[24]  C. Shields,et al.  Enucleation technique for children with retinoblastoma. , 1992, Journal of pediatric ophthalmology and strabismus.

[25]  H. Buettner,et al.  Tissue breakdown and exposure associated with orbital hydroxyapatite implants. , 1992, American journal of ophthalmology.

[26]  R. Goldberg,et al.  Exposed hydroxyapatite orbital implants. Report of six cases. , 1992, Ophthalmology.

[27]  C. Shields,et al.  Hydroxyapatite orbital implant after enucleation. Experience with initial 100 consecutive cases. , 1992, Archives of ophthalmology.

[28]  J. Dutton Coralline hydroxyapatite as an ocular implant. , 1991, Ophthalmology.

[29]  C. Shields,et al.  Histopathologic evidence of fibrovascular ingrowth four weeks after placement of the hydroxyapatite orbital implant. , 1991, American journal of ophthalmology.

[30]  A. Perry Integrated orbital implants. , 1990, Advances in ophthalmic plastic and reconstructive surgery.

[31]  S. Morax Use of GORE-TEX (polytetrafluoroethylene) in the anophthalmic socket. , 1990, Advances in ophthalmic plastic and reconstructive surgery.

[32]  D. Osborne,et al.  Orbital growth after childhood enucleation. , 1974, American journal of ophthalmology.

[33]  R. Kennedy Growth retardation and volume determinations of the anophthalmic orbit. , 1973, American journal of ophthalmology.

[34]  C. M. Luce A Short History of Enucleation , 1970 .