Abstract
Purpose
To investigate the results when using the acellular dermal allograft (SureDermⓇ, Hans Biomed Co., Korea) as a new wrapping material for porous orbital implants.
Methods
The charts of 11 patients who underwent either primary or secondary insertion of MedporⓇ orbital implants after enucleation or a new insertion after removal of previous orbital implants were reviewed. MedporⓇ orbital implants either 18 or 20 mm were wrapped with SureDermⓇ in 4×4 cm sections that were 1-mm-thick. Four rectus muscles were fixed to the SureDermⓇ wrapped implant, and a conjunctival suture was made with 6-0 Vicryl. All patients had follow-up periods longer than 10 months and were evaluated to determine the success of wrapping and to identify any complications.
Results
The average age of the patients was 48.3 years. The patients wore artificial eyes for 9 weeks after the operation, and the follow-up periods were 22.4 months on average. There was no case of implant or SureDermⓇ exposure, inflammation, and other significant complications except in one case that required fornix reconstruction to allow the subject to wear an artificial eye.
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Figure 1.
(A) An orbital implant is wrapped around with SureDermⓇ of 4×4 cm size using 6-0 Vicryl suture. (B) Four rectangular windows are made at the posterior part of wrapped implant. (C) Deep tunnels into the center of the implant are made by 18-gauge needle to facilitate vascularization. (D) Four rectus muscles fixation sites are marked at the anterior surface of SureDermⓇ-wrapped implant with gentian violet. (E) After making four windows at SureDermⓇ, deep tunnels into the center of the implant are made in the same manner. (F, G) The wrapped implant is inserted into the orbit by using disposable inserter aid.(H) Isolated four rectus muscles are fixed at windows of SureDermⓇ-wrapped implant by 6-0 Vicryl suture. (I) Closure of Tenon’s layer and conjunctiva are done by 6-0 Vicryl suture.
![jkos-49-1371f1.tif](/upload/SynapseXML/0035jkos/thumb/jkos-49-1371f1.gif)
Figure 2.
Photograph of successfully sustained SureDermⓇ-wrapped orbital implants and well-healed conjunctiva at postoperative 14 months (A, B), 22 months (C).
![jkos-49-1371f2.tif](/upload/SynapseXML/0035jkos/thumb/jkos-49-1371f2.gif)
Table 1.
Patients characteristics and clinical results of SureDermⓇ wrapping of porous orbital implant
No. | Sex | Age | Preoperative Dx | Type of surgery | Size of Iimplant | Prosthesis wearing | State of SureDermⓇ wrapped implant | Complications | Additional Tx. for complications | Post op F/U |
---|---|---|---|---|---|---|---|---|---|---|
1 | F | 66 | Phthisis bulbi | 1’insertion | 20 mm | 6 wks | Well sustained | None | None | 22 mo |
2 | F | 64 | Phthisis bulbi | 1’insertion | 20 mm | 4 wks | Well sustained | None | None | 25 mo |
3∗ | F | 60 | Anophthalmos, enophthalmos | 2’insertion | 20 mm | 6 wks | Well sustained | None | None | 30 mo |
4 | F | 49 | Anophthalmos,LL sag§ | 2’insertion | 20 mm | 9 wks | Well sustained | IFS∏ | CFW c TT# | 15 mo |
5 | F | 39 | Anophthalmos, enophthalmos | 2’insertion | 20 mm | 4 wks | Well sustained | None | None | 28 mo |
6 | M | 56 | Anophthalmos,DSSD‡ | 2’insertion | 20 mm | 6 wks | Well sustained | None | None | 34 mo |
7∗ | F | 44 | Implant exposure | Remo+Ne w | 20 mm | 34 wks | Well sustained | IFS, CWD†† | Fornix reconstruction | 14 mo |
8 | M | 43 | Implant | Remo+New† | 20 mm | 10 wks | Well sustained | IFS, CWD | CFW c TT | 17 mo |
9 | M | 34 | Implant infection | Remo+Ne w† | 20 mm | 6 wks | Well sustained | None | None | 38 mo |
10 | F | 75 | Implant infection | Remo+Ne w† | 20 mm | 8 wks | Well sustained | None | None | 10 mo |
11 | M | 1 | Retinoblastoma | 1’insertion | 18 mm | 6 wks | Well sustained | None | None | 13 mo |
µ | 48.3 | 9 wks | 22.4 mo |