Hydroxyapatite implants--a new trend in enucleation and orbital reconstructive surgery.

As treatment modalities evolve in ophthalmology one must assess and re-evaluate current methods of therapy in the care and treatment of the patient facing the loss of an eye. With the advent of Hydroxyapatite Orbital Implants, new challenges face the ophthalmic nurse in caring for the patient undergoing enucleation and reconstructive surgery. Integrated orbital implants are used to replace the volume of the orbit when the eye is removed due to enucleation, evisceration, or as secondary orbital implants. Various materials have been used in the past to replace orbital volume, with the most common being silicone or polymethylmethacrylate. Hydroxyapatite is a new orbital implant material which has unique interconnected porous matrix derived from marine corals with a mineral composition similar to bone. This orbital implant undergoes fibrovascular ingrowth by the patient's own tissue, becoming truly integrated and less likely to reject, migrate or extrude. The hydroxyapatite implant may be inserted with a variety of surgical techniques, all of which are more complex than standard enucleation implant techniques and have special considerations for the ophthalmic registered nurse.