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January 1995

Use of the Hydroxyapatite Ocular Implant in the Pediatric Population-Reply

Author Affiliations

Philadelphia, Pa

Arch Ophthalmol. 1995;113(1):17. doi:10.1001/archopht.1995.01100010018006

In reply  We thank Mazow and Trawnik for their interest in our article "Use of the Hydroxyapatite Ocular Implant in the Pediatric Population."1 They expressed concern regarding oversizing the hydroxyapatite implant in children. We agree that placement of an obviously oversized implant could increase the risk of conjunctival thinning and erosion and could decrease prosthesis motility by foreshortening the conjunctival fornices. Therefore, our recommendation has been that an appropriately sized hydroxyapatite implant should be deeply buried in the socket with tedious closure of the overlying Tenon's fascia and conjunctiva.1,2 Our experience suggests that 16- or 18-mm implants are not oversized but are of the appropriate diameter when considering the size of the eye in a child under 3 years of age. In our series, there were five children with conjunctival thinning and two with conjunctival dehiscence. Five of these children received an 18-mm hydroxyapatite sphere, and two received

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