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D. Gupta, N. Ramey, M. J. Richard, J. A. Woodward; Comparison of Complications From Porous Anophthalmic Orbital Implants. Invest. Ophthalmol. Vis. Sci. 2010;51(13):24.
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Few studies have evaluated the clinical outcomes of aluminum oxide anophthalmic orbital implants relative to other porous implants. In this retrospective chart review we aim to (1) determine the complication rates, particularly implant exposure, of aluminum oxide, hydroxyapetite, and polyethylene orbital implants and (2) evaluate the relationship between clinical risk factors and complications after orbital implant placement.
We reviewed the medical charts of patients receiving a hydroxyapetite, porous polyethylene (MEDPOR), or aluminum oxide (bioceramic) implant for any indication between January 1999 and June 2009 at the Duke Eye Center (Durham, NC). These operations were conducted by eight different surgeons. Early (within 6 months) and late (after 6 months) post-operative complication categories included exposure, pain, discharge, orbital contracture, infection, and need for conjunctival closure or explantation.
After applying exclusion criteria, 126 patients were included in this study. Implant types included hydroxyapetite (n=78), porous polyethylene (n=20), and aluminum oxide (n=28). A total of 10.5% of the entire patient cohort experienced implant exposure. Exposure of hydroxyapetite, polyethylene, and aluminum oxide implants were 6.4%, 10%, and 23.1%, respectively. Aluminum oxide implants were associated with greater risk for early discharge, early pain, and early closure. Porous polyethylene implants were associated with greater risk for late explantation. Patients with prior trauma or a surgical indication of trauma were at increased odds to experience early complications.
We conclude that implant material may affect clinical outcomes following orbital implant placement. This study also provides preliminary evidence that patients with trauma history may experience greater rates of surgical complications after orbital implant placement.
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