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Abstract: Objective: To introduce the clinical effect among patients who received an unwrapped orbital implant with high density porous polyethylene material (Medpor) after enucleation or evisceration. Methods: Retrospective analysis of a series of 302 patients with anophthalmia who underwent placement of an unwrapped high density porous polyethylene orbital implant. We compared the patients (n=180) who accepted primary implant placement with those (n=122) who accepted secondary implant placement. Parameters evaluated included: age at time of surgery, date of surgery, sex, implant type and size, surgery type, the surgical procedure and technique performed, and complications. Results: The time of follow-up ranged from 2.0 to 58.0 months (mean 32.5 months). A total of 5 of 302 (1.66%) cases had documented postoperative complications. The following problems were noted after surgery: implant exposure, 3 patients (0.99%); implant removed due to orbital infection, 1 patient (0.34%); ptosis, 1 patient (0.34%). There were no significant complications observed in other 297 cases and all implants showed good orbital motility. The clinical effect of primary implant placement is better than that of secondary placement. Conclusion: high density porous polyethylene material can be used successfully as an unwrapped orbital implant in anopthalmic socket surgery with minimal complications. The material is well tolerated, nonantigenic and has low rate of infection and migration.

[1] Buetter, H., Bartley, G.B., 1992. Tissue breakdown and exposure associated with orbital hydroxyapatite implants. Am. J. Ophthalmol., 113:669-673.

[2] de Potter, P., Duprez, T., Cosnard, G., 2000. Postcontrast magnetic resonance imaging assessment of porous polyethylene orbital implant (Medpor). Ophthalmology, 107(9):1656-1660.

[3] Gayre, G.S., De, B.C., Lipham, W., 2001. Bovine pericardium as a wrapping for orbital implants. Ophthal. Plast. Reconstr. Surg., 17:381-387.

[4] Jordan, D.R., Klapper, S.R., 1999. Wrapping hydroxyapatite implants. Ophthalmic. Surg. Lasers, 30:403-407.

[5] Jordan, D.R., Gilberg, S., Mawn, L., 1998. The synthetic hydroxyapatite implant: a report on 65 patients. Ophthal. Plast. Reconstr. Surg., 14:250-255.

[6] Kao, S.C., Chen, S., 1999. The use of rectus abdominis sheath for wrapping of the hydroxyapatite orbital implants. Ophthalmic. Surg. Lasers, 30:69-71.

[7] Karesh, J.W., Dresner, S.C., 1994. High-density porous polyethylene (Medpor) as a successful anophthalmic socket implant. Ophthalmology, 101:1688-1696.

[8] Lee, V., Subak, S.I., Hungerford, J.L., 2000. Exposure of primary orbital implants in postenucleation retinoblastoma patients. Ophthalmology, 107(5):940-946.

[9] McNab, A., 1995. Hydroxyapatite orbital implants. Experience with 100 cases. Aust. N. Z. J. Ophthalmol., 23:117-123.

[10] Naugle, T.C., Lee, A.M., Haik, B.G., Callahan, M.A., 1999. Wrpping hydroxylapatite orbital implants with posterior auricular muscle complex grafts. Am. J. Ophthalmol., 128(4):495-501.

[11] Oestreicher, J.H., Liu, E., Berkowitz, M., 1997. Complications of hydroxyapatite orbital implants. A review of 100 consecutive cases and a comparison of Dexon mesh (polyglycolic acid) with scleral wrapping. Ophthalmology, 104:324-329.

[12] Perry, A.C., 1991. Advances in enucleation. Ophthalmol. Clin. North Am., 4:173-182.

[13] Remulla, H.D., Rubin, P.A., Shore, J.W., 1995. Complications of porous spherical orbital hydroxyapatite implants. Ophthalmology, 102:586-593.

[14] Trichopoulos, N., Augsburger, J.J., 2005. Enucleation with unwrapped porous and noporous orbital implants: a 15-year experience. Ophthalmic Plastic and Reconstructive Surgery, 21(5):331-336.

[15] van Acker, E., de Potter, P., 2001. Implant orbitaire en polyethylene poreux (Medpor). J. Fr. Ophtalmol., 24:1067-1073.