Ding Xia, Su Dai, Cao Yuan, Zhu Xiaowei, Xing Yue, Lin Ming, Li Jin
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200025, People's Republic of China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Graefes Arch Clin Exp Ophthalmol. 2025 Jul;263(7):2025-2032. doi: 10.1007/s00417-025-06785-x. Epub 2025 Mar 12.
To analyze intraorbital Hydroxyapatite(HA) implant exposure occurring beyond ten years of implantation and suggest potential contributing factors.
A retrospective cohort study based in the Shanghai Ninth People's Hospital.
One hundred and one Chinese patients with HA implant exposure were identified, from which 38 patients with implants exposure after ten years of insertion were selected and analyzed for demographic and medical records, clinical manifestations, surgery type, implant size, exposure area, follow-up duration, complications, details regarding prosthesis care, and treatment methods. All of the removed implants were sent for an HE pathologic examination.
The 38 cases experienced exposure 10 to 19 years after implantation and presented to the clinic with increased secretions, proliferation of granulation tissue, visible suture exposure, and difficulty in wearing the external prosthesis. Other complications included implant forward position in 3 patients, eyelid retraction in 4 patients, and all the patients presented with post-enucleation socket syndrome. Reviewing the medical history, HA implant sizes ranged from 18 to 22 mm. Fourteen patients underwent implant repair surgery, of which 2 experienced recurrence, and ultimately, 26 implants were removed. Of the 26 removed implants, histologic examination showed that 17 exhibited chronic infection, and 12 had limited fibrovascular ingrowth. The questionnaires indicated that 26 patients did not renew the external prosthesis regularly.
This study identified late complications and potential risk factors for implant exposure beyond ten years of implantation, including chronic infection, non-absorbable sutures, and low and delayed vascularization.
分析眼眶内羟基磷灰石（HA）植入物植入超过十年后发生的暴露情况，并提出潜在的促成因素。
基于上海第九人民医院的一项回顾性队列研究。
确定了101例HA植入物暴露的中国患者，从中选择38例植入十年后发生植入物暴露的患者，分析其人口统计学和病历、临床表现、手术类型、植入物大小、暴露区域、随访时间、并发症、假体护理细节及治疗方法。所有取出的植入物均送去做苏木精-伊红（HE）病理检查。
这38例患者在植入后10至19年发生暴露，临床症状为分泌物增多、肉芽组织增生、可见缝线暴露及佩戴外部假体困难。其他并发症包括3例患者植入物向前移位，4例患者眼睑退缩，所有患者均出现眼球摘除后眼窝综合征。回顾病史，HA植入物大小在18至22毫米之间。14例患者接受了植入物修复手术，其中2例复发，最终取出26枚植入物。在取出的26枚植入物中，组织学检查显示17枚有慢性感染，12枚纤维血管长入受限。问卷调查表明26例患者未定期更换外部假体。
本研究确定了植入十年后植入物暴露的晚期并发症及潜在风险因素，包括慢性感染、不可吸收缝线以及血管化不足和延迟。
