Synthetic Hydroxyapatite As Integrated Orbital Implant

Abstract

The use of HA as an orbital implant to improve motility was devised by Arthur

Perry, and its use in the orbit was approved by the FDA in August 1989. <38

The ideal ocular implant should be completely buried; simple in construction without projecting or angulated surfaces that might erode though the conjunctiva, lightweight, and smaller than the globe to allow for prosthesis of adequate anterior chamber depth. In addition, it should be centered within the muscle cone, and anchored to orbital tissues to minimize extrusion. It should have extra-ocular muscles attached, and should be directly integrated in some way with the prosthesis for 1:1 transfer of motility. It should induce minimal tissue inflammation and should not resorb over time. HA implanted as described above fulfills all of these criteria. Clinical trials over

the past several years, proved that the technique to be safe and effective<74

with no significant complications<78

Coralline HA as an ocular implant appears to offer a significant improvement over all previously used materials. However, the cost of the implant, represents a major obstacle in the reconstructive process. That is why, we tried in this study, to test another implant material (synthetic HA), that is half-priced the price of Coralline HA. There were a number of indications to proceed with the reconstructive technique of ocular implant that included atrophic globes, blind-painful eyes, severely traumatized globes, endophthalmitis, and intra-ocular malignancy.