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H. R. Shah, M. R. Vagefi, J. R. Burroughs, W. H. Bearden, R. L. Anderson, M. T. Yen; An Analysis of Clinical Outcomes of the Quasi-Integrated Porous Polyethylene Orbital Implant. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2301.
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Common indications for enucleation include intraocular malignancy, trauma, and a blind, painful eye. After the enucleation, an implant is placed in the socket in order to replace orbital volume and provide support and motility for a prosthesis. The most commonly used porous polyethylene implant allows fibrovascular ingrowth, and therefore prevents migration and extrusion. However, optimal motility is achieved with the placement of a peg or screw, which is associated with a high rate of complications. The new quasi-integrated porous polyethylene orbital implant has four anterior mounds, creating channels through which the rectus muscles are placed. It is hypothesized this implant has the benefit of the porous polyethylene implant, while providing additional improvement in motility with few complications. The purpose of this study is to analyze the outcomes of patients who had the quasi-integrated porous polyethylene orbital implant placed following enucleation or evisceration.
Charts were reviewed of all patients who underwent placement of quasi-integrated porous polyethylene orbital implant following enucleation or evisceration, excluding those with retinoblastoma. Information collected includes primary ocular disease, age, duration of disease, past medical history, past treatments, type of surgery, surgical course, path report from specimen, size of implant, complications, time from surgery to complications, time between surgery and prosthesis, type of prosthesis.
Forty-seven patients underwent placement of the quasi-integrated porous polyethylene implant. The most common diagnosis for surgery was phthisis. Average length of follow-up was 11.6 months. Of twenty-three enucleation patients no complications were noted. Of the 24 evisceration patients, 4 had implant exposure (16.6%). Three were repaired surgically, and one self sealed.
The quasi-integrated porous polyethylene implant is well tolerated in most patients. The incidence of implant exposure was higher in patients who underwent evisceration suggesting a need for careful closure and close follow-up in these patients.
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