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July 1991

The Osseointegration Technique for the Rehabilitation of the Exenterated Orbit

Author Affiliations

From the Oculoplastic, Orbital and Oncology Service, Department of Ophthalmology (Drs Nerad and Carter), and Department of Otolaryngology (Dr LaVelle and Ms Fyler), University of Iowa Hospitals and Clinics, Iowa City; and University of Gothenberg (Sweden) (Dr Branemark).

Arch Ophthalmol. 1991;109(7):1032-1038. doi:10.1001/archopht.1991.01080070144054

• Osseointegrated implants can be used successfully to support maxillofacial prostheses. Six patients (aged 37 to 80 years; average age, 68 years) underwent orbital exenteration for eyelid neoplasms infiltrating into the orbit. Each patient underwent a two-stage osseointegration procedure in preparation for fitting an orbital prosthesis. In the first stage, three or four bone-anchored fixtures were placed into the bony orbital rim. Skin penetration and abutment placement were performed in the second-stage operation, performed 3 to 6 months later. Successful osseointegration was achieved in 17 (94.4%) of 18 fixtures in five nonirradiated patients. All five patients were successfully fitted with an implant-retained prosthesis. One patient who underwent irradiation lost all four fixtures that had been placed. This patient chose to wear a black patch rather than a conventional prosthesis held in with adhesive. Average follow-up was 16 months for the five patients who were successfully fitted with orbital prostheses (range, 6 to 30 months).

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