Background: Secondary reconstruction of the anophthalmic socket is frequently challenging. A number of surgical techniques are described to improve the cosmetic and functional outcome. Recently, the use of hydroxyapatite as a primary orbital implant after enucleation has gained popularity and yielded encouraging surgical results. There are no published reports concerning the use of hydroxyapatite as a secondary orbital implant in anophthalmos.
Methods: The authors reviewed the charts of 17 patients who received a secondary hydroxyapatite orbital implant to rehabilitate the anophthalmic socket. Each patients' preoperative and postoperative photographs, socket appearance, implant and prosthetic motility, and overall impressions of the surgical outcome were analyzed. Complications of surgery and secondary procedures were reviewed.
Results: All except one patient attained an improved prosthetic appearance postoperatively and 76% achieved improved implant and prosthetic motility. Four patients undergoing surgery early in the series had worsening of pre-existing ptosis. In two patients, implant exposure developed; a socket infection with subsequent loss of the implant developed in one of these patients. Eight patients underwent additional eyelid and orbital surgery at the time of secondary implant surgery, whereas nine patients required additional staged procedures.
Conclusion: Secondary orbital implantation with the coralline hydroxyapatite sphere is an encouraging alternative to traditional secondary orbital implant surgery. Surgical outcomes in this study were excellent with few complications and high patient satisfaction.