*Orbital and Adnexal Service, Department of Ophthalmology, †Department of Pathology, Villa Tiberia Hospital, Via Emilio Praga;and ‡Department of Ophthalmology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, Roma, Italy.
Ophthalmic Plast Reconstr Surg. 2014 Mar-Apr;30(2):132-6. doi: 10.1097/IOP.0000000000000028.
To perform a histopathological review of exposed porous orbital implants requiring explantation and to study the clinical outcome of replacement of the exposed implant with an autologous dermis-fat graft.
Case series. Analysis of the clinical charts of 25 patients (age 5 to 62 years) who were submitted to explantation of exposed hydroxyapatite orbital implants, followed by simultaneous replacement with a dermis-fat graft by 1 oculoplastic surgeon between 2000 and 2011. A histopathological and microbiological evaluation of implant sections was performed. This study adheres to the principles outlined in the Declaration of Helsinki.
Microbiological examination showed the presence of Gram-positive cocci infection in 59% of the patients. Histopathological examination showed the presence of a chronic inflammatory infiltrate in 22 of the implants (88%) and significantly reduced fibrovascular colonization of the implant in all patients.
The reduction of fibrovascular ingrowth resulted in poor integration of the implant in the eye socket. The exposure allowed bacterial colonization of the implant, causing a chronic inflammatory infiltrate. A dermis-fat graft at the same time of explantation can be considered a suitable surgical option in both adults and children: only minor complications may occur, and cosmetic results are satisfactory.
对需要取出的暴露多孔眶内植入物进行组织病理学检查，并研究用自体真皮脂肪移植物置换暴露植入物的临床结果。
病例系列研究。对 2000 年至 2011 年间由 1 位眼整形医生对 25 例（年龄 5 至 62 岁）暴露羟基磷灰石眶内植入物患者进行暴露植入物取出并同时用真皮脂肪移植物置换的临床病历进行了分析。对植入物切片进行了组织病理学和微生物学评估。本研究符合赫尔辛基宣言中规定的原则。
微生物学检查显示 59%的患者有革兰阳性球菌感染。组织病理学检查显示 22 个植入物（88%）中有慢性炎症浸润，所有患者的植入物纤维血管化均明显减少。
纤维血管化的减少导致植入物在眼眶中的整合不良。暴露使植入物发生细菌定植，引起慢性炎症浸润。在取出的同时使用真皮脂肪移植物可以被认为是成人和儿童的一种合适的手术选择：仅可能出现轻微并发症，且美容效果令人满意。
