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Bio-eye Presentation Slide Set

Page 10 of 11



91. Secondary Implant



92. A young lady with a secondary Bio-eye hydroxyapatite orbital implant showing excellent motility. Approximately 12 years have passed between her primary enucleation and her secondary implant.



93. Hydroxyapatite Implants


Arthur C. Perry M.D. 5/85 - 8/91

Total Implants        141

  Enucleations         46    33%

  Eviscerations        19    13%

  Secondary            76    54%



94. Complications
Extrusion 2 (1.4%)

  • Acute infection - implants replaced

Exposures 8 (6%) 2 technique

  • 3 Removed and replaced with HA
  • 5 Covered and or healed

These are markedly low complication rates given historicl trends for other orbital implants. A 1992 study by Hornblass showed traditional (allen, Iowa, etc.) implants have a mean extrusion rate of 20% and a mean migration rate of 32%; with significantly lower motility.



95. Complications

  • Exposure of implant before vascularization
  • Drilling of implant before vascularization



96. Complications of vascularized implant

  • No migration
  • No extrusion
  • No chronic infections

To date there have been no migrations, no extrusions, and no chronic infections in a well-vascularized hydroxyapatite implant; including those that have been drilled for the motility/support peg.



97. Exposure

  • Poor closure technique
  • Implant too large
  • Implant not deep enough in orbit

The implant surface is very rough. Good closure is essential to prevent erosion of Tenon's capsule and the conjuctiva. This is one advantage of wrapping the implant in sclera or some other material.



98. Exposure

  • Implant not wrapped or capped
  • Contracted socket
  • Poor tissue quality - radiation

An implant must be of the proper size, and must be placed deep within the muscle cone. One of the few inhibitors of good vascularization is an orbit with compromised vascularity due to radiation treatment.


(Click image to enlarge)
99. Exposure of hydroxyapatite prior to vascularization. The Bio-eye orbital implant must be treated as any other implant until it has vascularized. Only then can it deliver its most desirable characteristics: low-levels of migration, exposure, extrusion, and excellent motility via the motility/support peg.


(Click image to enlarge)
100. Exposure of hydroxyapatite prior to vascularization. The Bio-eye orbital implant must be treated as any other implant until it has vascularized. Only then can it deliver its most desirable characteristics: low-levels of migration, exposure, extrusion, and excellent motility via the motility/support peg.


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