Complications of hydroxyapatite orbital implants - A review of 100 consecutive cases and a comparison of Dexon mesh (polyglycolic acid) with scleral wrapping

Purpose: The authors analyzed all the complications associated with the first 100 hydroxyapatite orbital implants performed by one surgeon, and compare scleral wrapping versus Dexon mesh (polyglycolic acid, Davis & Geck, Manati, Puerto Rico) wrapping in light of these complications. Background: Prior studies have not included the full range of complications that can occur with hydroxyapatite orbital implants. Dexon mesh implant wrapping is a promising substitute for sclera and avoids the risks involved in using donor tissue. Methods: A retrospective analysis of 100 consecutive cases was performed. Results: Many minor complications occurred, but the rate of exposure was low (3%) and no implant was lost. Dexon mesh wrapping was similar to scleral wrapping with respect to complications, although more posterior implant placement was necessary to avoid exposure in the Dexon-wrapped group. Conclusions: Surgeons and patients must be prepared for many minor complications when using hydroxyapatite orbital implants, but these can be readily overcome. Dexon mesh wrapping of the implant is recommended to avoid using donor tissue.