Repair of exposed hydroxyapatite orbital implants by subconjunctival tissue flaps.

PURPOSE: The purpose of the study was to determine the feasibility of the use of subconjunctival tissue flaps to repair exposed hydroxyapatite (HA) orbital implants.

METHODS

One hundred thirty-eight consecutive patients underwent repair of exposed HA orbital implants via a procedure that involved the creation of subconjunctival tissue flaps. After the superior and inferior subconjunctival flaps were created, they were sutured together in the tension-free state to seal the exposure. During follow-up examinations, complications were assessed.

RESULTS

Twelve patients were lost after the 3-month follow-up, leaving 126 patients who were followed from 12 to 60 months (average, 24 months). Problems occurred in 22 patients (17.5%), including recurrence of exposure in 4 patients (3.2%), ptosis in 12 patients (9.5%), pyogenic granulomas in 1 patient (0.8%), a conjunctival cyst in 1 patient (0.8%), implant infection in 1 patient (0.8%), and poor transfer of movement in 3 patients (2.4%).

CONCLUSIONS

The use of the subconjunctival tissue flaps for repairing exposed HA orbital implants is a promising alternative for the management of implant exposure. Although this novel technique is associated with some complications, these problems can be minimized by careful case selection and careful surgery.