Extraocular Myoplasty: Surgical Remedy For Intraocular Implant Exposure (original) (raw)
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Eye, 2014
Purpose To describe and to evaluate a new and relatively easy technique for porous implant exposure repair. Methods Eleven patients with exposed porous orbital implants after evisceration were included in this study. Five patients with large exposures (diameter47 mm) and six patients with small exposures of orbital implants (diametero7 mm) that persisted despite posterior vaulting of the prosthesis and usage of antibiotics and steroids for more than 6 weeks, underwent revision surgery with the remove-rotate-reimplant technique (3R technique). Negative microbiological culture taken from the exposed socket surface before surgery was the major inclusion criterion. Five patients with insufficient conjunctival tissue also underwent additional mucosa or hard palate grafting of the defect in addition to the remove-rotate-reimplant procedure. Results Patients have been followed up for more than 18 months (ranging from 18-30 months). None of them received motility peg insertion after repair. Implant reexposure was detected in one patient during the follow-up period, which was managed by dermis fat grafting with implant removal. Conclusion The remove-rotate-reimplant technique is an effective surgical method for repairing exposed porous anophthalmic implants after evisceration with a 90% success in this study. It avoids the removal of the implant from the sclera, which is a traumatic procedure that may lead to the tearing and loss of scleral tissue covering the implant. Saving the porous implant and scleral cover reduces the surgical time and cost.
Developments in Health Sciences, 2020
PurposeOur aims were to evaluate the primary and clinical evisceration indications and to analyse orbital implant related complications.Materials/methodsWe included in our retrospective review all eviscerations between 2006 and 2016 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary. Primary evisceration indications were classified into six groups: trauma, surgical diseases, infections or inflammations, systemic diseases, tumours and unclassifiable diseases. Clinical immediate evisceration indications were also classified into six groups: painful blind eye due to glaucoma, atrophia/phthisis bulbi, endophthalmitis, cosmetic reasons, acute trauma and expulsive bleeding.ResultsEvisceration was performed in 46 eyes of 46 patients (54.3% males, age 43.0 ± 18.6 years). The most common primary evisceration indications were trauma (37%), surgical diseases (34.8%), infection or inflammation (10.9%), systemic diseases (6.5%), tumours (8.7%) and unclassifiable disea...
Complications of Porous Spherical Orbital Implants
Ophthalmic Plastic & Reconstructive Surgery, 1996
To determine the complications observed with using porous spherical orbital implants (hydroxyapatite and porous polyethylene) and the factors leading to their occurrence.
Evisceration with acrylic spherical implant: An evaluation
2021
Purpose: The purpose of this study is to assess the acceptance, of non-integrated acrylic implant in terms of cosmesis, patient comfort, socket component as well as the comparison of these parameter between eyes with and without implant. Materials and Methods: A total of 25 eyes with specific indications for sacrificing the eye were randomly divided with 2 groups of with and without implant. Ocular parameters were taken before and after surgery. Results: Follow up assessment was done post operatively, at 2nd week, 4th week and 6 months after surgery. In the immediate post operative period, the symptoms of pain, discharge and discomfort were present in all patient belonging to either group. However, on future follow up of 1st week these complaints were significantly less in the group without implant. At 6 months serous, non infectious discharge was present in 20% of the study population of both the groups. Evaluation of the post operative socket in terms of infection, superior sulcus...
An evaluation of acrylic spherical implant in cases of evisceration
2017
Purpose: To evaluate the acceptance of implant and cosmetic results achieved following evisceration operation with use of non integrated spherical acrylic implant. Method: The patient included in the study were taken from the out patient department of upgraded department of ophthalmology B.R.D Medical College; Gorakhpur, from December 2015 to November 2016. Since the study involved mutilating surgery of eye only those patients were selected in whom either there was specific indication for sacrificing the eye or there was no chance of any visual recovery. In all, 40 patient formed the study group of whom, 32 cases were panopnthalmitis; 4 were of endophthalmitis and 4 were of anterior staphyloma. Detailed history taken and examination done under (a) General examination (b) Systemic examination and (c) Detailed ocular examination. Procedure and its probable ultimate outcome along with complications was explained to patients and only those patients who willingly accepted for surgery wer...
A Study of Primary Orbital Implants Following Evisceration Surgery
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND Eye is known to be the most important sensory organ of communication and expression of our feelings. Loss of this organ may lead to impairment of vision, disfigurement and psychological trauma. Evisceration is a destructive surgical procedure, in which intraocular contents are removed along with inner two coats, retaining the sclera and optic nerve. Aim-To study the surgical outcome among different types of primary orbital implants following evisceration surgery and find out incidence of complications associated with them. MATERIALS AND METHODS 20 cases were selected during 2 years period (May 2016-April 2018) with various indications for evisceration. Patients' records were kept for demographics, surgical indications, implant types, follow-up and any reported complications after surgeries. Patients with a minimum of 6 months follow-up period were included in the study. Evaluation was done among various types of implants used, their associated complications and the patient's satisfaction following surgery. Design-A prospective observational study. RESULTS A total of 20 patients (aged between 19-and 73-year-old) underwent evisceration with primary orbital implant during 2016-2018. The most common indications for the surgical intervention were painful blind eye attributable to trauma (45%) followed by infection and inflammation (40%), primary glaucoma (5%) and others (10%). Out of 20 patients, PMMA implant was implanted in 10 patients (50%), hydroxyapatite in 5 patients (25%) and silicone implant in 5 patients (25%). Implant motility was slightly better in patients with hydroxyapatite implants when compared to PMMA and silicone implants. No significant complications were noted except for one case of orbital implant exposure, who was given hydroxyapatite implant (18 mm). Most of the patients were satisfied and happy with the results. CONCLUSION Primary orbital implants provide an excellent way to replace the volume loss following evisceration surgery. Provided the proper technique is used for surgery, good motility and cosmesis can be achieved postoperatively without significant complications.
Acta Ophthalmologica, 2017
Background: Secondary orbital implantation surgery can be complex due to scarring of the orbital tissues and can be complicated by implant exposure and extrusion. Purpose: To evaluate the incidence and risk factors of implant exposure and extrusion following secondary alloplastic orbital implantation surgery in anophthalmic patients. Methods: Retrospective analysis of a consecutive series of patients who underwent secondary placement of an alloplastic orbital implant by one surgeon between 2001 and 2016 in the Rotterdam Eye Hospital. Outcome parameters: implant exposure or extrusion. Other complications. Results: Sixty-three patients underwent secondary orbital placement of scleralwrapped acrylic (60) or silicone (three) spherical implants. A subset of 25 patients had undergone earlier secondary orbital implant placement (by other surgeons) with exposure/extrusion necessitating additional implant surgery. Two patients were excluded due to lack of follow-up (<3 months). Mean age was 49 years (range: 1-84.5 years). The mean follow-up was 4.1 years (range: 0.25-13, 6 years). Implant exposure or extrusion occurred in six of 18 (33%) patients in whom no muscle had been reattached during secondary orbital implantation and in five of 43 (12%) patients in whom the extraocular recti muscles had been attached, but the follow-up time was shorter for the latter group. Surgical treatment for implant exposure/ extrusion was required in eleven of 61 patients (18%). Other complications included postoperative volume deficiency despite optimal prosthesis (five of 61, 8%), inclusion cysts (four of 61, 7%) and conjunctivitis sicca (two of 61, 3%). Seven of 61 (11%) patients required fornix deepening and seven (11%) blepharoptosis correction. Conclusion: Secondary orbital implantation of sclera-wrapped alloplastic implants was complicated by implant extrusion or exposure in 12% of cases in which the extraocular muscles were attached to the implant.
Evisceration with primary orbital implant in endophthalmitis/ panophthalmitis
IP International Journal of Ocular Oncology and Oculoplasty, 2023
To describe the outcome of Evisceration with the primary orbital implant in non-seeing eyes with and without ocular infection (endophthalmitis/panophthalmitis). Materials and Methods: A prospective, nonrandomized comparative case series research was performed from 2019 to 2022. Patients with the least postoperative follow-up of 6 months were included in the study. One seventy-three eyes of one seventy-three patients were included. Group A involved the infective patients, and Group B included all noninfective blind eyes. Nonporous PMMA implants were used for all cases, and the main outcome measure was the successful retention of the primary implant. All types of complications and satisfactory prosthesis fitting were also observed. Results: The mean (±SD) age was 45.689 ± 11.34 years, with males (53.2%) predominant. All except 11 cases could retain the primary implant successfully. Primary orbital implants were exposed in nine (5.2%) cases (four in Group A and five in Group B), and Extrusion of the primary orbital implant occurred in two (1.1%) cases, and all extrusion occurred in Group A. One hundred fifty-six (90.2%) patients underwent successful prosthesis fitting with better cosmesis. The difference in major complications like implant exposure and implant extrusion between the groups was not statistically significant (P value equals 0.0879, Fisher exact test). Conclusion: Evisceration with a primary orbital implant is feasible in both infective (endophthalmitis/ panophthalmitis) and noninfective blind eyes. It provides a better postoperative cosmesis to the anophthalmic socket. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.