HIGH-DENSITY POROUS POLYETHYLENE (MEDPOR) AS A SUCCESSFUL ANOPHTHALMIC SOCKET IMPLANT

Background: High-density porous polyethylene (Medpor) has been used su ccessfully as an implant in orbital fracture repair and in the managem ent of both cosmetic and post-traumatic facial deformities. The materi al is well tolerated, resists infection, is nonantigenic, and promotes tissue ingrowth. Additionally, sutures can be passed through it. Thes e characteristics led to its use as an implant in anophthalmic socket surgery. Methods: Twenty-one patients with anophthalmia underwent impl antation of spherically shaped high-density porous polyethylene implan ts. The implant was used in six primary enucleations with direct extra ocular muscle attachment, ten secondary implant insertions, one repeat secondary implant insertion, and five eviscerations. Results: Postope rative follow-up averaged 19 months. During this period, there were no extrusions, infections, significant inflammatory responses, or implan t exposures. One implant was removed 4 months after insertion due to i nadequate initial placement secondary to a severe post-traumatic orbit al deformity. Successful re-implantation was performed without complic ation. Postoperatively, all sockets showed good to excellent motility. Results of histologic examination of the removed implant demonstrated minimal inflammatory response and extensive fibrovascular ingrowth in volving 60% of the implant substance. Conclusions: This initial report indicates that high-density porous polyethylene can be used successfu lly as an implant in anophthalmic socket surgery. Its advantages over other similar implants include a significantly lower material cost and the ability to suture the extraocular muscles directly to it without the need for a covering material such as fascia or sclera. Experimenta l studies are in progress to determine if this implant can be integrat ed with an ocular prosthesis to promote improved motility and cosmesis .