Hydrox yapatite Implantation with Scleral Patch Graft in Eviseration

Park, Kyung Sook; Kim, Jae Duck; Kim, Sang Duck

Abstract

When inserting an orbital implant, evisceration allows suitable movement of the eyeball making it a better method cosmetically than enucleation; performing hydroxyapatite implantation after evisceration preserving the cornea sometimes causes the complication of cornea melting. To reduce complications after evisceration and hydroxyapatite implantation,scleral patch graft with corneal excision was performed in 15 eyes of 15 patients. In all 15 eyes, 20 mm-sized hydroxyapatite implants were inserted. Fourteen eyesshowed no complications, but in one eye scleral suture was exposed and 2months later the implant was exposed around that area. Also, there developed conjunctival wound dehiscence and exposure of the central portion of the scleral graft in two eyes. But the exposed sclera was fibrovascularized by the surrounding conjunctival tissue and did not lead to exposure of the implant. This study suggests that when performing evisceration and hydroxyapatite implantation, scleral pach graft with cornea excision is helpful in reducing the incidence of exposure of hydroxyapatite implant.