Heimann H., Bechrakis N. E., Kreusel K. M., Foerster M. H.

Augenklinik des Universitätsklinikums Benjamin Franklin der FU Berlin, Hindenburgdamm 30, D-12200 Berlin

Background: Enucleation of the globe is the most often used therapeutic modality in the treatment of retinoblastoma. Following enucleation, different types of implants can be used to obtain an acceptable cosmetic result. Silicone implants coated with neuro-patch® are a low-priced alternative to more expensive hydroxy-apatit implants.
Material and methods: Between January 1998 and March 2000, a total of ten 16mm silicone implants coated with neuro-patch® were used following enucleation for retinoblastoma. The patients` age ranged from 3 months to 3,2 years (median 10 months). The follow-up period was between 10 months and 2.2 years (median 20 months).
Results: In four out of ten patients, a wound dehiscence could be seen between 2 months and 1.5 years following enucleation. In two patients, the course was further complicated by an orbital cellulites. A revison of the conjunctical wound was sufficient in two cases, in the two other cases, an exchange of the orbital implant was necessary. Macroscopically, no connection between the patch and the orbital tissues could be seen in the two explanted specimens. Histologically, only a low-grade infiltration of cells could be demonstrated within the patch.
Conclusion: The implantation of silicone implants coated with neuropatch ® was associated with severe complications in 4 out of 10 cases in our series. As comparable problems could not be seen using other types of implants or the same type in adults, we cannot recommend the use of neuro-patch® coated implants following enucleation in children.

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