CORALLINE HYDROXYAPATITE SPHERES AS SECONDARY ORBITAL IMPLANTS IN ANOPHTHALMOS

Background: Secondary reconstruction of the anophthalmic socket is fre quently challenging. A number of surgical techniques are described to improve the cosmetic and functional outcome. Recently, the use of hydr oxyapatite as a primary orbital implant after enucleation has gained p opularity and yielded encouraging surgical results. There are no publi shed reports concerning the use of hydroxyapatite as a secondary orbit al implant in anophthalmos. Methods: The authors reviewed the charts o f 17 patients who received a secondary hydroxyapatite orbital implant to rehabilitate the anophthalmic socket. Each patients' preoperative a nd postoperative photographs, socket appearance, implant and prostheti c motility, and overall impressions of the surgical outcome were analy zed. Complications of surgery and secondary procedures were reviewed. Results: Ail except one patient attained an improved prosthetic appear ance postoperatively and 76% achieved improved implant and prosthetic motility. Four patients undergoing surgery early in the series had wor sening of pre-existing ptosis. In two patients, implant exposure devel oped; a socket infection with subsequent loss of the implant developed in one of these patients. Eight patients underwent additional eyelid and orbital surgery at the time of secondary implant surgery, whereas nine patients required additional staged procedures. Conclusion: Secon dary orbital implantation with the coralline hydroxyapatite sphere is an encouraging alternative to traditional secondary orbital implant su rgery. Surgical outcomes in this study were excellent with few complic ations and high patient satisfaction.