Ocular Implants



Anophthalmos - Cosmetic & reconstructive surgery

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

Spheres for Enucleation and Evisceration

Surgeons may possibly 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.

Bioceramic Implants

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

Please read on to understand the full story!

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 may possibly 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 may possibly may possibly 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 may possibly 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.

Conical Orbital Implant

  • 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.

 

Conical Orbital Implant

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 may possibly occur leading to somewhat unpredictive and result of volume.
  • Dermis fat graft may possibly 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 may possibly 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 may possibly 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 may possibly be abraded with {the} derma-brader or with a #15 blade.

Harvest fat ready for implant

  • 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.

 

Donor site of the buttocks from which the fat is harvested. The skin is dermabraded, is about 25 mm in diameter

 

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

 

 

 

 

Procedures
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