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P.H. Spitellie, M. Thakker, J. Zhang, B.S. Sires; Fibrovascular ingrowth and Osteogenesis in a Human Hydroxyapatite Orbital Implant 10 Years After Implantation . Invest. Ophthalmol. Vis. Sci. 2004;45(13):32.
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Purpose: We report the histological findings of an hydroxyapatite orbital implant removed 10 years after implantation. Methods: A hydroxyapatite implant and polycarbonate motility peg were excised from the left orbit of a 44–year old woman who suffered from a chronically inflamed and painful anophthalmic socket. The specimen was decalcified and stained for routine microscopy and infectious organisms. Bacterial and fungal cultures were also obtained. Results: There was complete fibrovascularization of the implant with approximately 90% ossification. No bone marrow was identified. Histologic sections revealed fibrous connective tissue at the periphery of a sclerotic bony mass with a central acute inflammatory infiltrate at the motility peg drill site. Peripherally, there appeared to be granulation tissue associated with giant cell formation. Although a few lymphoid aggregates with germinal centers were present within the specimen, there were no bacterial, mycobacterial, or fungal organisms identified histologically. Conclusions: Porous hydroxyapatite orbital implants are amenable to fibrovascularization and extensive ossification. In addition, polycarbonate motility pegs may induce chronic inflammation, necessitating removal of the peg or implant.
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