EVISCERATION WITH HYDROXYAPATITE IMPLANT - SURGICAL TECHNIQUE AND REVIEW OF 31 CASE-REPORTS

Purpose: To evaluate the use of hydroxyapatite (HA) as an orbital impl ant with evisceration. Background: Although several reports have docum ented good success with HA orbital implants and their use with enuclea tion, only a few reports mention HA with evisceration. These few repor ts are less favorable, with exposure rates as high as 67%. In contrast , the authors have had good success with evisceration and HA implants with no major complications and a low exposure rate. Methods: A retros pective analysis of all eviscerations with HA implant performed betwee n January 1989 and July 1993 was completed (n = 31). Patients underwen t evisceration with scleral modification, including anterior relaxing incisions and posterior sclerotomies to accommodate a large sphere wit hout tension on the wound. Patient records were reviewed for demograph ic data, surgical indication, sphere size, clinical outcome, complicat ions, and follow-up interval. The surgical technique is described. Res ults: All 31 patients underwent successful surgery with complications limited to exposure (6%), mild superior sulcus deficit (6%), and a con junctival cyst (3%). No patient required further socket reconstruction , and no patient required peg placement to enhance motility. The avera ge follow-up interval was 13.3 months. Conclusions: The authors have h ad good success using HA orbital implants for evisceration without maj or complications. Primary evisceration with HA implantation after post erior sclerotomies is a safe and effective method for treating patient s with a blind, painful eye.