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Study shows bioceramic orbital implant exposure after more than 90 days postop
Ophthal Plast Reconstr Surg. 2010;26(2):80-82.
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A majority of bioceramic orbital implant exposures occurred after the 90-day postoperative interval, according to a study.
"Implant exposures can occur anytime post-implant placement," the study authors said. "This review discovered an implant exposure rate of 9.1%, with the majority of the exposures occurring after the postoperative follow-up period. Patients with porous orbital implants should be followed on a long-term basis to detect this complication."
The retrospective clinical case series included 419 anophthalmic patients who received a bioceramic aluminum oxide orbital implant. Patients who presented to five surgeons in a 7-year period, received implants and had at least 3 months of follow-up were included.
Investigators analyzed age, gender, type of surgery, implant size, peg type, follow-up time, time of pegging and complications. Data from 353 patients who were followed for 3 months to 96 months were highlighted.
Study data showed that implant exposure occurred in 32 implants (9.1%). Six exposures (19%) occurred during the 90-day postoperative interval, and 26 exposures (81%) occurred after the immediate postop period, the authors reported.
Porous orbital implant exposures can occur at any time after primary or secondary implantations following enucleations or eviscerations.
This study demonstrates some of the inherent difficulties in retrospectively evaluating exposure rates of orbital implants due to a variety of surgical technique-related and non-technique- related factors that can directly and indirectly affect the exposure rates. I was as surprised as the authors at the unusually high overall exposure rate of 9.1% in this study. Overall exposure rates in other similar studies with other porous materials typically do not reach this level. I do not feel that this rate should be directly related to the bioceramic material (aluminum oxide) per se. A randomized, prospective, case-controlled study comparing the exposure rates of multiple porous implants might be more beneficial to future comparisons of implant exposure rates.
– Charles B. Slonim, MD, FACS
OSN
Oculoplastic and Reconstructive Surgery Board Member
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