Coralline hydroxyapatite sphere in orbit restoration.

Purpose. To restore the anophthalmic socket, primarily or secondarily, using a hydroxy-apatite sphere (HA). Methods. We used HA in 33 patients (25 male, 8 female), aged from 4 to 68 years (mean 38. 1 years) for 19 primary and 14 secondary implantations. HA spheres measured 16 mm in one patient, 18 mm in 21 and 20 mm in 11. The spheres were wrapped in donor sclera preserved in absolute alcohol. All six extraocular muscles were isolated, in the cases where this was possible. Buccal membrane was grafted in three patients to restore the fornices. Drilling was done on four patients using a 3.8 serrated plastic sheath. Results. During follow-up of 7 - 69 months we observed no complications except for slight edema in the immediate postoperative period. All patients gained very good to excellent motility of the implant, acceptable symmetric appearance in the case of primary implantation, and a dramatic improvement of facial appearance in the case of secondary implantation. Conclusions. HA spheres are an excellent orbital implant for primary and secondary restoration of the anophthalmic socket causing no serious complications.