Biomaterials for orbital implants and ocular prostheses: Overview and future prospects

Anophthalmic socket: choice of orbital implants for reconstruction

“…Therefore, the pegging system is rarely used at present (10) . However, if pegging is not planned, there is no advantage in terms of mobility when using porous orbital implants instead of solid silicone spheres (4) . Many surgeons were encouraged to use the integrated implants as a new option to solve the problems of extrusion that occurred with the non-integrated implants.…”

“…The follow-up of patients was decisive for identifying problems that may occur with the integrated implants, which were at least as common as those with the non-integrated implants. Dehiscence of the conjunctiva and sclera were increasingly frequent, and the exposure rates ranged from 2.9% to 62%, which were influenced by many factors such as the surgical technique employed (enucleation or evisceration), removal of the cornea or not (20) , the use of wraps or not, the length of follow-up, and systemic diseases in the anophthalmic socket (2,4,21,22) . Ultimately, it is impossible to state whether extrusion or the need to remove implants will not occur when using integrated implants.…”

“…The most widely used implant format is spherical but other formats may be available, such as conic, pear shaped, "ball-and-ring, " and quasi integrated (4) . The main reason for changing the implant format depends on the movement of implants and researchers are aiming to develop an implant that facilitates a better transmission of extraocular muscular movements to the external prosthesis.…”

“…Several case reports indicate that complications have occurred with all of the different types of implants. Randomized studies and long-term follow-up are required to conclusively determine the performance of implants (4,19) . Therefore, according to the current state-of-the-art and for the implants that exist in the market, it is possible to affirm that there is no ideal implant and that the integrated implants do not perform better than the non-integrated implant (2) .…”

“…The use of natural hydroxyapatite was followed by other integrated or porous implants, such as synthetic hydroxyapatite and porous polyethylene (4,(17)(18)(19) . The follow-up of patients was decisive for identifying problems that may occur with the integrated implants, which were at least as common as those with the non-integrated implants.…”