Ocular Implants



Implant Types

magnets, gold, silver, glass, silicone, cartilage, bone, fat, cork, titanium mesh, acrylics, wool, rubber, catgut, peat, agar, polyethylene, hydroxyapatite


MEDPOR® Biomaterial

MEDPOR® is comprised of a lightweight, porous form of high-density polyethylene, a material with a long history of medical applications. Its unique, highly porous texture allows vessels to incorporate into {the} enhancement shape, integrating MEDPOR® into a patient's tissues. The shape and size can be customized by your surgeon to fit your individual needs. MEDPOR® eliminates {the} need for grafts or silicone implants.

MEDPOR® Orbital Spheres

Surgeons might select from sphere implant diameters of 14 mm to 22 mm. A resterilizable sizer set is available for selecting {the} appropriate implant diameter at {the} time of surgery.

COI ®Implants

The Conical Orbital Implant (COI) ® was designed and developed to address numerous of {the} common problems associated with {the} correction of {the} anophthalmic socket. The COI® design provides removal of {the} anterior surface of {the} channels in {the} medial, lateral and inferior quadrants.

Bio-Ceramic 

 

  • Bioceramic Orbital Implant made of {the} porous, strong, non-brittle biomaterial alumina (Al2 03)
  • features highly uniform interconnected pores of approximately 500mm in size.
  • The extensive pore system enhances fibrovascular ingrowth which keeps {the} implant from migrating and allows {the} secure attachment of extraocular muscles, thereby improving implant motility.

Hydroxyapatite:

 

  • The Bio-eye hydroxyapatite (HA) ocular implant is a spherical (ball-shaped) implant composed of natural coralline HA.

  • It is used to replace {the} volume of {the} orbit when {the} eye is surgically removed, or as a replacement implant in patients with a poorly functioning, pre-existing implant.

  • Historically, {the} use of nonporous synthetic ocular implants has led to complications such as exposure, extrusion, migration, infection, poor motility, and poor cosmesis

Surgical Choices and Techniques

  • In 1989, corraline sphere shaped implants were introduced. Hydroxyapatite is an inert, biocompatible and nontoxic material that has been in use in {the} medical field for over 15 years. Hydroxyapatite is a calcium phosphate hydroxide compound made up of multiple interconnecting pores. Because this is an inert porous substance, once implanted into {the} orbit it becomes vascularized and hence an integral part of {the} orbit. In recent years, porous polyethylene implants have been utilized in a similar fashion
  • Ocular Implants provide surgeons with porous biocompatible implants for orbital reconstruction following enucleation and evisceration procedures. The interconnecting, omni directional pore structure of {the} MEDPOR® Biomaterial allows for rapid vascularization and soft tissue in growth.
  • Surgeons might select from sphere implant diameters of 14mm to 22mm. A resterilizable sizer set is available for selecting {the} appropriate implant diameter at {the} time of surgery.
  • It might might be easily shaped with a scalpel. Its lightweight property, {the} biocompatibility of {the} porous polyethylene, and {the} ability to place {the} implant deep in {the} socket contribute to {the} overall popularity of this implant.
  • Motility might be enhanced by suturing {the} extra ocular muscles directly to {the} implant or to an overlying fascia or scleral wrap. As with all orbital implants, it is important to have a tension free closure over {the} implant.

 

Other Shapes and Options:

 

  • Designed in Conjunction with Peter A.D. Rubin, M.D.
  • The Conical Orbital Implant (COI)® was designed and developed to address numerous of {the} common problems associated with {the} correction of {the} anophthalmic socket. The COI ® design provides removal of {the} anterior surface of {the} channels in {the} medial, lateral and inferior quadrants.

  • Unique design elements have been incorporated into {the} overall conical shape, including a superior projection and channels for {the} rectus muscles. The volume of {the} superior aspect of {the} implant is to help reduce {the} possibility of a post operative superior sulcus defect.
  • This shape is intended for use after standard enucleation procedures. The implant is primarily intended to (1) fill {the} void volume resulting from an enucleated eye, (2) provide a method for reattaching {the} rectus muscles, and (3) provide a compatible surface for an overlying ocular prosthesis.

 

Dermis-fat graft

  • is composed of subcutaneous fat and overlying dermis.
  • Its advantages include {the} fact that it is an autologous graft and, thus, lacks concerns for bio-compatibility in disease transmission. However, there is a certain degree of fat atrophy which might occur leading to somewhat unpredictive and result of volume.
  • Dermis fat graft might be used as a primary procedure following primary reconstruction for orbital exenteration, as a low cost means to provide an orbital implant and in instances in which enucleation is performed early in childhood since {the} fat might grow and provide stimulus for orbital growth.
  • Dermis fat graft can also be used in numerous secondary procedures such as a replacement of an extruded orbital implant and correction of deep superior sulcus deformity.

 

  • The surgeon might choose one of several donor sites including {the} lower abdominal quadrant and {the} outer quadrant of {the} buttock.
  • Typically a graft is measured approximately 25 mm in diameter. The epidermis might be abraded with {the} derma-brader or with a #15 blade.

  • The graft is harvested with an attempt to minimize mechanical manipulation of {the} graft and to quickly insert {the} graft into {the} previously prepared recipient bed.
  • Often {the} dermis has slight surgical modifications in order to create a dome shape to it which often provides better motility for {the} prosthetic implant.

 

 

Complications from dermis fat graft include atrophy, central graft ulceration, granuloma formation, cyst formation, keratinization, hair growth, symblepharon, or/and donor site morbidity.

 

 

 

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