Purpose: The purpose of this study is twofold: to assess the incidence and implications of complications unique to placing a freestanding polycarbonate peg in patients with hydroxyapatite implants and to compare the incidence of complications in these patients with the incidence in patients with non-pegged hydroxyapatite implants.
Methods: This is a retrospective clinical case series of 103 patients who underwent hydroxyapatite implant insertion at our institution. The incidence of postoperative complications in patients who underwent freestanding polycarbonate pegging procedures (n = 21) and those who had not (n = 82) were compared.
Results: One postoperative complication—infection—occurred in a significantly higher percentage of patients in the pegged group (42.9%, 9/21) compared with the non-pegged group (19.5%, 16/82), (p = 0.037). Fifteen of the 21 patients (71.4%) in the pegged group experienced complications unique to freestanding polycarbonate pegging. Overall, 95.2% (20/21) of patients in the pegged group experienced a complication compared with 58.5% (48/82) of patients in the non-pegged group, (p = 0.001). In addition, there was an average of 3.1 (66/21) complications per patient in the pegged group compared with an average of 1.9 (106/82) complications per patient in the non-pegged group (p = 0.010).
Conclusions: Patients who received a freestanding polycarbonate pegged implant had a high risk of experiencing complications unique to pegging, and therefore a significantly higher rate of complications overall when compared with patients whose implant was not pegged. In addition, patients who received a pegged implant had a higher incidence of infection. However, most patients retained their pegs despite complications.
Most patients with hydroxyapatite implants and a freestanding polycarbonate peg experience more complications than those with non-pegged hydroxyapatite implants, although most retain their pegs.
W.K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan Health System, Ann Arbor, MI, U.S.A.
Accepted for publication November 20, 2006.
Address correspondence and reprint requests to Dr. Bartley R. Frueh, W.K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, 1000 Wall Street, Ann Arbor, MI 48105, U.S.A.