Introduction. Removal of the eyeball is a radical surgical manipulation and leads to a significant aesthetic defect in appearance. Compared with enucleation, eye evisceration using an orbital implant has a number of advantages. Ocular prosthetics is the main method of medical and social rehabilitation in patients of this category. The purpose of the study was to explore the possibility of using porous titanium nickelide implants to form the eyeball orbital stump in an in vivo experiment.
Material and methods. The experiment was performed on 30 animals (dogs) and included evisceration followed by the formation of the musculoskeletal eyeballorbital stump. The eyeball orbital stump formation was carried out with an implant made of porous titanium nickelide of the TN-10 brand which was inserted it into the scleral sac. The process of connective tissue ingrowth into the implant pores was investigated 10 days, 1, 3, 6, 9 months and 1 year after surgery. After these periods, the implants were extracted from the body, microscopic examination of the microsectionsurfaces of the extracted objects and histological analysis of the implant adjacent tissues were performed.
Results. Analysis of the obtained structures showed that loose connective tissue was already observed ten days after implantation in almost all pores. After 1–-3 months, connective tissue and its compaction were observed in all the pores of the implant. In the period of 6 months – 1 year, the connective tissue in the pores along the entire thickness of the examined implants was characterized by the same density. At the 10th day after titanium nickelide implantation the eyeball tissues histological analysis showed a moderate inflammatory reaction and the formation
of a capsule around the implant of loose-fibrous connective tissue. One month after the operation, the implant was covered with a mature connective tissue capsule, which was significantly compacted 3 months after implantation.
Conclusion. The use of an implant made of porous titanium nickelide, due to its frame properties and porous structure, ensures rapid fibrovascular tissue ingrowth of the implant, providing its stable fixation in surrounding tissues, stable shape of the eyeball stump, reduces the risk of exposure and implant rejection.
Key words: ophthalmologic surgical procedures, eye evisceration, orbital implant, titanium nickelide, nitinol
Conflict of interest. The authors declare that there is no conflict of interest.
Funding. There was no funding for this study.
Terletskaya E.N., Medvedev Yu.A., Petruk P.S. The use of poroustitanium nickelide implants for the formation of the eyeball locomotor stump after evisceration. Head and neck. Russian magazine = Head and neck. Russian Journal. 2022;10(2):19–24