Complications associated with secondary orbital implantations

Abstract

Purpose: To evaluate complications associated with secondary procedures for orbital implants.

Methods: A retrospective review was made of the records of patients who had undergone a secondary orbital implantation at a tertiary referral centre at St Erik Eye Hospital in Stockholm, Sweden, from 1998 up to and including the first half of 2009. Implant-related complications were noted as was demographic and surgical background data. The regional ethics committee in Stockholm gave its approval for this study.

Results: Seventy-one patients had received a secondary orbital implant at the eye hospital. Implant-related complications were noted in 24 patients (34%), and 20 patients required reoperation/s (28%). There were five types of complications: migration of the implant (13%), insufficient orbital volume (10%), exposure/extrusion/infection (8%), mechanical obstruction (1%) and socket oedema (1%). Analyses of sizes and types of implants, wrapping and surgical techniques did not reveal any specific factor that resulted in an increased number of complications. However, there was an indication that aluminium oxide might be associated with fewer complications (2/11 = 18%).

Conclusion: Our results show that secondary orbital implantations have high complication rates and that further surgery is needed in more than a quarter of cases. It is important to consider these facts when planning to insert secondary implants and to provide patients with accurate information about the procedure and possible outcomes.

Keywords: complication; exposure; infection; migration; orbit; reoperation; secondary implant; volume.