We read the article by De Potter et al1 in the February issue of the Archives that describes the use of sclera-wrapped hydroxyapatite implants in children. De Potter et al considered the potential risks associated with the use of sclera-wrapped hydroxyapatite implants. Specifically, scleral tissue had to be checked and treated to prevent the transmission of human immunodeficiency virus, viral hepatitis, other infectious diseases, and systemic cancers. They also mentioned their concerns that the calcium phosphate containing hydroxyapatite could inhibit the detection and treatment (eg, radiotherapy) of orbital retinoblastoma noted after surgery. They also indicated that lateral canthotomies had to be performed routinely to allow implantation of the relatively large prostheses for the small orbits of children. But, in spite of these potential added risks and costs compared with polymethylmethacrylate implants, there was no mention of informed consent or internal review board approval.
The potential benefits of this technique
Finger PT, Packer S. Use of the Hydroxyapatite Ocular Implant in the Pediatric Population. Arch Ophthalmol. 1995;113(1):16-17. doi:10.1001/archopht.1995.01100010018005