Long-Term Outcomes and Measuring Vascularisation of Three-Dimensional Printed Porous Polyethylene Orbital Implant in Enucleation and Evisceration
Keywords:
Prosthesis, Orbit, Reconstruction, EyeAbstract
Objective: To report the long-term outcome in terms of safety and efficacy of a new three-dimensional printed
polyethylene (3DP-PE) orbital implant in patients who required orbital reconstruction after eye removal and to measure
area of fibrovascular ingrowth in the orbital implant by using ImageJ software.
Methods: Prospective, consecutive selection in 21 patients which met the criteria. Each case had evisceration,
enucleation, or secondary orbital implant performed by one of three oculoplastic surgeons. A gadolinium-enhanced,
1.5-Tesla MRI scan was performed at least 6 months after surgery. The follow-up time was at least 12 months. Safety
was measured in terms of infection and tissue reaction to the implant. Efficacy was measured in terms of exposure rate,
grades of fibrovascular ingrowth and postoperative results in long-term follow-up. Comparison of vascularisation of
first and second MRI scans was measured by subjective technique and ImageJ software.
Results: The mean age was 40.4 ± 15.3 years old (range, 18-73 years old). 57.1% of patients had evisceration
procedures. The mean follow-up time was 64.0 ± 37.4 months (range, 18-128 months). No postoperative infection was
reported. The exposure rate was 19%. A total of four patients had two MRI scans and 75% of patients had increased
enhancement at the second MRI scan, using subjective technique and ImageJ software. The correlation in interpretation
of enhancement techniques between subjective technique and ImageJ software was 50%.
Conclusion: A 3DP-PE orbital implant is safe in terms of infection rate in long term follow-up.
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