Jpn J Ophthalmol 46, 103–107 (2002) © 2002 Japanese Ophthalmological Society 0021-5155/02/$–see front matter Published by Elsevier Science Inc. PII S0021-5155(01)00459-2 Complications in Motility Peg Placement for Hydroxyapatite Orbital Implant in Anophthalmic Socket Sang Yeul Lee*, Jae Woo Jang † , Helen Lew ‡ , Sung Joo Kim* and Hye Young Kim § *Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea; † Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea; ‡ Department of Ophthalmology, Pochon CHA University College of Medicine, Sungnam, Korea; § Department of Ophthalmology, Korea Medical Insurance Ilsan Hospital, Goyang, Korea Purpose: In a retrospective study, we evaluated the complications in using the motility peg system (nonsleeved and sleeved) for hydroxyapatite orbital implants in an anophthalmic socket. Methods: Drilling for motility peg placement was performed in 265 patients with hydroxya- patite implantation: nonsleeved peg system (n = 191), sleeved peg system (n = 74). A statis- tical analysis was performed using the chi-square test. Results: Extrusion rates were significantly lower in the sleeved peg system (10.8%) com- pared to the nonsleeved peg system (27.2%) (P = .005). The other complications related to motility peg placement were granulation tissue overgrowth (4.2%), hydroxyapatite exposure around peg head (3.0%), and decentered peg (1.9%). Conclusions: To minimize peg extrusion, the sleeved peg was better than the nonsleeved peg for use in primary motility peg placement. Jpn J Ophthalmol 2002;46:103–107 © 2002 Japanese Ophthalmological Society Key Words: Complications in motility peg placement, hydroxyapatite, nonsleeved peg, peg extrusion, sleeved peg. Introduction Porous allograft materials including hydroxyapatite and porous polyethylene have been commonly used in integrated orbital implants for the anophthalmic socket. The rates of postoperative complications have been reported to be lower with the hydroxyapatite or- bital implant than with most conventional implant materials. 1 There are a few complications, such as conjunctival erosion and implant exposure, but seri- ous complications, fortunately, are rare. 2–5 The risk factors and management of these complications have been widely discussed. 6–9 The main advantage of the porous orbital implant is improved cosmetic results. The prosthesis is more natural in appearance because of increased motility. Prosthesis motility is achieved through a surgically placed motility peg that transfers the increased mo- bility of the implant to the prosthesis. We report herein the complications occurring in 265 patients after drilling for motility peg placement in the hydroxyapatite implant. Materials and Methods The study group consisted of 265 patients who un- derwent enucleation (125 patients), evisceration (65 patients), or secondary procedure (75 patients) with hydroxyapatite implantation and subsequent place- ment of a motility peg, between May 1992 and De- cember 1997 at Yonsei Medical Center. The mean Received: November 27, 2000 Correspondence and reprint requests to: Sang Yeul LEE, MD, Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, CPO Box 8044, Seoul 120-752, Korea