Exposure of expanded polytetrafluoroethylene-wrapped hydroxyapatite orbital implant: A report of two patients

Purpose: Hydroxyapatite (HA) spheres used to replace volume after an enucle ation are often wrapped with autologous tissue before orbital implantation. Man-made materials are less expensive and pose no risk for viral transmiss ion. The use of expanded polytetrafluoroethylene (ePTFE) to wrap HA spheres was evaluated. Methods: The medical records of 2 consecutive patients who underwent uncomp licated implantation of an HA sphere wrapped in ePTFE were reviewed. Results: An unusual reaction to the ePTFE material that was nonresponsive t o topical or systemic antibiotic therapy developed in these 2 patients. Eve ntual wound erosion and bacterial infection of the implant necessitated its removal. Conclusions: Although well tolerated in other surgeries, ePTFE, when used t o wrap HA spheres and placed into the orbit, may cause persistent conjuncti val discharge, pyogenic granuloma formation, and eventual wound erosion. Th erefore, the use of this material to wrap HA spheres is not recommended.