Ophthalmology 2013-06-01

Pediatric anophthalmic sockets and orbital implants: outcomes with polymer-coated implants.

Maria Kirzhner, Yevgeniy Shildkrot, Barrett G Haik, Ibrahim Qaddoumi, Carlos Rodriguez-Galindo, Matthew W Wilson

Index: Ophthalmology 120(6) , 1300-4, (2013)

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Abstract

To compare wrapped and polymer-coated hydroxyapatite implants in children undergoing primary enucleation with no adjuvant therapies.Retrospective, interventional cohort study.All children undergoing primary enucleation without adjuvant therapies between 1999 and 2009 at a tertiary pediatric cancer hospital.Review and analysis of patient records.Implant exposure, extrusion and migration, socket contracture, and formation of pyogenic granuloma.Sixty consecutive patients undergoing primary enucleation with no adjuvant chemotherapy or radiation with follow-up of at least 12 months were included. Retinoblastoma was the diagnosis in 59 eyes (98.3%). Median follow-up was 3.6 years (range, 1.0-9.3 years). Two implant sizes were used: 20 mm in 47 patients (78.3%) and 18 mm in 13 patients (21.7%). Overall, 52 patients (86.7%) had an event-free recovery. Polymer-coated hydroxyapatite implants (43/60, 71.7%), when compared with wrapped ones (17/60, 28.3%), had a trend toward greater event-free recovery (odds ratio [OR], 1.6; 95% confidence interval [CI], 0.3-7.7) and lower exposure rate (OR, 2.1; 95% CI, 0.4-10.5).The use of polymer-coated hydroxyapatite implants is associated with favorable outcomes in the pediatric population. Despite observed complications, long-term implant retention is possible in most children.The author(s) have no proprietary or commercial interest in any materials discussed in this article.Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.