Linna Lu1, Wodong Shi, Min Luo, Ying Sun, Xianqun Fan. 1. Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Abstract
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.
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.
Authors: Kriti Mohan; Joshua A Cox; Ryan M Dickey; Paula Gravina; Anthony Echo; Shayan A Izaddoost; Anh H Nguyen Journal: Semin Plast Surg Date: 2016-05 Impact factor: 2.314