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Pegging the Porous Orbital Implant

Purpose: Hydroxyapatite (HA) orbital implants are commonly used for the anophthalmic socket. With a HA implant, if motility is not satisfactory then a peg system can be surgically placed in attempts to improve motility. The authors report the technique and results of 83 patients who received motility peg placement over an 8-year period by a single surgeon. Methods: Retrospective chart review of all patients with previous enucleation with either primary or secondary insertion of a HA implant who received a motility peg by a single oculoplastic surgeon between January 1999 and February 2007. Results: Eighty-three patients underwent placement of a titanium peg and sleeve during the study period. Complications seen in the follow-up period included discharge, pyogenic granuloma, and others. Infection was experienced in 1 case. Fourteen patients (17%) required further surgical management due to complications. Conclusions: The largely positive results of this moderately sized case series validates the efficacy of pegging a hydroxyapatite orbital implant with minor risk of serious complications; this may have been due to a combination of factors including an experienced surgeon and adequate follow-up. As a procedure that can be completed in a hospital or minor surgical suite with sedation, it remains a viable option for many patients.