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RB Avery, MJ Lucarelli; A Comparison of Porous Polyethylene Enucleation Implants With and Without Acellular Dermis Wrapping . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1469.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the complication rate of wrapping with acellular dermis (Alloderm) versus not wrapping orbital implants placed during enucleation. Methods: A review of twenty-three spherical porous polyethylene (MEDPOR) implants placed by the same surgeon over a three year period. All patients underwent posterior placement of the implant, attachment of the rectus muscles anteriorly on the implant, and closure of posterior and anterior Tenon's. Patients were followed at least 9 months. Complications were identified by review of the medical record, contact with an ocularist, and/or direct contact with the patient. Complications evaluated included socket inflammation, infection, and implant exposure. Infections were identified by clinical signs and the need for topical antibiotics more than 2 months after the enucleation. Results: During the period of interest, 39 patients underwent enucleation with placement of a spherical MEDPOR implant. 17 were wrapped in Alloderm and 22 were unwrapped. A total of 16 patients were excluded due to insufficient follow-up (less than 9 months following enucleation). 12 wrapped implants and 11 unwrapped implants were included in the final analysis. The mean follow-up time was 20 months for wrapped and 19 months for unwrapped implants. One wrapped implant showed exposure 17 months after enucleation. No unwrapped implants developed exposure. Two patients from the wrapped group and two from the unwrapped group required antibiotics for conjunctivitis after the immediate post-operative period. Conclusion: In this series there was no advantage to wrapping porous polyethylene implant with Alloderm with respect to socket inflammation, infection, or implant exposure. Wrapping of implants may add unnecessary time and cost to enucleation.
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