Foreign Body Granuloma Following Orbital Reconstruction with Porous Polyethylene

Timoney, Peter J.; Clark, Jeremy D.; Frederick, Paul A.; Krakauer, Mark; Compton, Christopher J.; Horbinski, Craig; Sokol, Jason A.; Nunery, William R.

doi:10.1097/iop.0000000000000328

Cited by 11 publications

(10 citation statements)

References 9 publications

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“…The data collected in the present work give evidence that the roughness (S q and S a ) of commercial non-porous polymeric implants is one order of magnitude lower than that of the porous ones ( Table 2 ). This is in apparent contradiction with most clinical literature showing that porous orbital implants—although having a higher surface roughness—are associated with a lower rate of complications (especially extrusion) compared to non-porous devices [ 25 , 26 , 27 ]. This issue can be explained considering that porous implants allow fibrovascularization, which permits small exposures to heal spontaneously and make the implant more amenable of “salvage procedures” [ 10 ].…”

Section: Resultsmentioning

confidence: 69%

Nanoscale Topographical Characterization of Orbital Implant Materials

2018

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The search for an ideal orbital implant is still ongoing in the field of ocular biomaterials. Major limitations of currently-available porous implants include the high cost along with a non-negligible risk of exposure and postoperative infection due to conjunctival abrasion. In the effort to develop better alternatives to the existing devices, two types of new glass-ceramic porous implants were fabricated by sponge replication, which is a relatively inexpensive method. Then, they were characterized by direct three-dimensional (3D) contact probe mapping in real space by means of atomic force microscopy in order to assess their surface micro- and nano-features, which were quantitatively compared to those of the most commonly-used orbital implants. These silicate glass-ceramic materials exhibit a surface roughness in the range of a few hundred nanometers (Sq within 500–700 nm) and topographical features comparable to those of clinically-used “gold-standard” alumina and polyethylene porous orbital implants. However, it was noted that both experimental and commercial non-porous implants were significantly smoother than all the porous ones. The results achieved in this work reveal that these porous glass-ceramic materials show promise for the intended application and encourage further investigation of their clinical suitability.

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Section: Resultsmentioning

confidence: 69%

Nanoscale Topographical Characterization of Orbital Implant Materials

2018

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“…[1,2,18,19] In the literature, several complications of PPEI use, such as foreign body reaction, hematoma, and enophthalmos, have been described. [20][21][22] It is a safe material, almost as common as autologous grafts in both acute orbital floor fractures and late complications. Wajih et al [23] found similar complication rates using bone graft and PPEI.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Özkaya

Erçöçen

2020

ENT Updates

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Objective: The porous polyethylene implant (PPEI) is one of the most commonly used alloplastic materials in cranio-maxillofacial surgery. It is widely preferred because of its biocompatible, durable, flexible and thin nature as well as for its low complication rates. The purpose of the present study was to review the clinical and surgical outcomes of PPEI usage for orbital floor fractures. Methods: The present study included 76 patients who underwent orbital floor fracture reconstruction using PPEI between July 2000 and July 2018. All demographic characteristics of the patients were recorded and the patients were questioned and/or examined whether there was any complaint or complication secondary to the surgery. Results: The mean age of the patients was 35.2 years with a male predominance. The most common causes of injury were in-vehicle traffic accidents, falls, physical assaults and pedestrian accidents, respectively. 73 patients had other concomitant fractures of the facial bones along with the orbital floor fracture. The mean time between the injury and the surgical repair was eight days. Scleral show was observed in two patients (2.6%) due to scar contracture of the subciliary incision whereas one patient had surgical removal of the PPEI. Conclusion: The present study revealed that PPEI is a reliable and flexible material for the reconstruction of orbital floor fractures with a low risk of complications. To prevent or minimize postoperative complications, the orbital septum must be repaired meticulously.

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“…[11] As orbital implants for fracture reconstruction, biocompatibility, available in several shapes, sizes, and insoluble characteristics are commonly accepted advantages of porous polyethylene. [17] …”

Section: Discussionmentioning

confidence: 99%

“…From the report of Timoney et al, [ 11 ] inflammatory giant cell reactions were observed in patients who underwent orbital fracture repairs with porous polyethylene implants, in which, foreign body granuloma formation was identified by H&E histologic sections.…”

Section: Introductionmentioning

confidence: 99%

Long-term infectious complications of using porous polyethylene mesh for orbital fracture reconstruction

Song

Sun

et al. 2016

Medicine

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Porous polyethylene is a widely used implants in orbital reconstruction, on which comprehensive clinical analysis, various treatments, and different prognosis according to specific classification principles on long-term complications have not been reported.To investigate the new clinical symptoms, intraoperative findings, treatments, and outcomes of complications long period after previous surgery, resulting from the use of porous polyethylene mesh for orbital fracture reconstruction.A retrospective study was conducted on 21 patients at the Department of Ophthalmology, Shanghai Ninth People's Hospital with orbital complications after orbital fracture reconstruction with porous polyethylene mesh for 4 ± 2.2 years from 2011 to 2013. These data included new clinical symptoms after previous surgery, computerized tomography data, intraoperative findings, treatments, and outcomes.Data from 21 patients were analyzed in this study. Two patients received conservative treatment, while the other 19 patients underwent surgical approaches. Classification principles for orbital complications after orbital wall defect reconstruction with porous polyethylene mesh were formulated according to patients’ new clinical symptoms, computed tomography (CT), and intraoperative findings after previous surgery. In the last follow-up, 19 patients (90.5%) were cured or improved according to our assessment principle. The follow-up ranged from 3 to 45 months (35 months in average).According to specific classification for orbital complications resulting from the use of porous polyethylene mesh for orbital fracture reconstruction, various medical treatments should be carried out, and the prognosis may be different.

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Foreign Body Granuloma Following Orbital Reconstruction with Porous Polyethylene

Cited by 11 publications

References 9 publications

Nanoscale Topographical Characterization of Orbital Implant Materials

Nanoscale Topographical Characterization of Orbital Implant Materials

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Long-term infectious complications of using porous polyethylene mesh for orbital fracture reconstruction

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