J Korean Ophthalmol Soc.  2008 Sep;49(9):1371-1378.

Wrapping of Porous Orbital Implant Using Acellular Dermal Allograft

• Jeong HO
• La TY

Abstract

PURPOSE
To investigate the results when using the acellular dermal allograft (SureDerm(R), Hans Biomed Co., Korea) as a new wrapping material for porous orbital implants.
METHODS
The charts of 11 patients who underwent either primary or secondary insertion of Medpor(R) orbital implants after enucleation or a new insertion after removal of previous orbital implants were reviewed. Medpor(R) orbital implants either 18 or 20 mm were wrapped with SureDerm(R) in 4x4 cm sections that were 1-mm-thick. Four rectus muscles were fixed to the SureDerm(R) wrapped implant, and a conjunctival suture was made with 6-0 Vicryl. All patients had follow-up periods longer than 10 months and were evaluated to determine the success of wrapping and to identify any complications.
RESULTS
The average age of the patients was 48.3 years. The patients wore artificial eyes for 9 weeks after the operation, and the follow-up periods were 22.4 months on average. There was no case of implant or SureDerm(R) exposure, inflammation, and other significant complications except in one case that required fornix reconstruction to allow the subject to wear an artificial eye.
CONCLUSIONS
Acellular dermal allograft appears to be a good substitute material if preserved sclera is not available when inserting orbital implants with wrapping.

Keyword

Acellular dermal allograft; Wrapping material of porous orbital implant

MeSH Terms

Eye, Artificial
Follow-Up Studies
Humans
Inflammation
Muscles
Orbit
Orbital Implants
Polyglactin 910
Sclera
Sutures
Transplantation, Homologous
Polyglactin 910

Figure

• 

  Figure 1. (A) An orbital implant is wrapped around with SureDermⓇ of 4×4 cm size using 6-0 Vicryl suture. (B) Four rectangular windows are made at the posterior part of wrapped implant. (C) Deep tunnels into the center of the implant are made by 18-gauge needle to facilitate vascularization. (D) Four rectus muscles fixation sites are marked at the anterior surface of SureDermⓇ-wrapped implant with gentian violet. (E) After making four windows at SureDermⓇ, deep tunnels into the center of the implant are made in the same manner. (F, G) The wrapped implant is inserted into the orbit by using disposable inserter aid.(H) Isolated four rectus muscles are fixed at windows of SureDermⓇ-wrapped implant by 6-0 Vicryl suture. (I) Closure of Tenon’s layer and conjunctiva are done by 6-0 Vicryl suture.

• 

  Figure 2. Photograph of successfully sustained SureDermⓇ-wrapped orbital implants and well-healed conjunctiva at postoperative 14 months (A, B), 22 months (C).

Reference

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