Long-Term Outcome of Staged Socket Surgery for Acquired Anophthalmos.
Journal
Ophthalmic plastic and reconstructive surgery
ISSN: 1537-2677
Titre abrégé: Ophthalmic Plast Reconstr Surg
Pays: United States
ID NLM: 8508431
Informations de publication
Date de publication:
19 Dec 2023
19 Dec 2023
Historique:
medline:
22
12
2023
pubmed:
22
12
2023
entrez:
22
12
2023
Statut:
aheadofprint
Résumé
To evaluate long-term outcomes of staged volume rehabilitation for acquired anophthalmos. Case-note review of patients who had preceding i) eye removal without implant, ii) eye removal with an intraconal implant, but ball-related problems, or iii) removal of exposed implant. Secondary interventions were a) a first-time ball implant, b) dermis-fat graft, c) ball repositioning, d) ball replacement after prior removal, or e) orbital floor implantation. Secondary volume-augmenting surgery was performed in 175 sockets at a mean age of 42.7 years (range 2-91), with 62% secondary ball implants, 3% dermis-fat grafts, 6% ball repositioning, 19% ball replacement after prior removal for exposure, and 10% having orbital floor implantation. After this surgery, further volume enhancement was required in 21% of sockets, this being 40% for spheres ≤18 mm diameter, in contrast to 6% for those ≥20 mm (p < 0.001). Exposure or malposition of the secondary implant occurred in 8% (12/151) and was unrelated to implant type, size, wrapping, or prior irradiation. Tertiary surgery addressed lining deficiency (18%) or eyelid malposition (25%). Overall, 92/175 (53%) had tertiary surgery to improve cosmesis and comfort, with 49% (36/92) being related to small implants. At a mean follow-up of 9.1 years, 82% of sockets had adequate volume, 79% had excellent lining, and 93% were comfortable. Prosthetic fit was satisfactory in 96% of cases, and 97% reported improved cosmesis. Over half of the sockets having planned 2-stage volume enhancement may need further procedures, especially after small-volume secondary implants, but, with meticulous surgery, reasonable long-term results can be achieved with few complications.
Identifiants
pubmed: 38133609
doi: 10.1097/IOP.0000000000002566
pii: 00002341-990000000-00304
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
Déclaration de conflit d'intérêts
The authors have no financial or conflicts of interest to disclose.
Références
Smit TJ, Koorneef L, Zonneveld FW, et al. Primary and secondary implants in the anophthalmic orbit preoperative and postoperative computed tomographic appearance. Ophthalmology 1991;98:106–110.
Jordan DR. Localization of extraocular muscles during secondary orbital implantation surgery: the tunnel technique: experience in 100 patients. Ophthalmology 2004;111:1048–1054.
Paik JS, Park HY, Cho WK, et al. Effects of secondary porous orbital implantation in anophthalmic sockets. J Craniofac Surg 2012;23:1677–1682.
Tyers AG, Collin JR. Orbital implants and post enucleation socket syndrome. Trans Ophthalmol Soc U K 1982;102 (Pt 1):90–92.
Sagoo MS, Rose GE. Mechanisms and treatment of extruding intraconal implants: socket aging and tissue restitution (the “Cactus Syndrome”). Arch Ophthalmol 2007;125:1616–1620.
Ruiters S, Mombaerts I. The prevalence of anophthalmic socket syndrome and its relation to patient quality of life. Eye (Lond) 2021;35:1909–1914.
Kaltreider SA, Jacobs JL, Hughes MO. Predicting the ideal implant size before enucleation. Ophthalmic Plast Reconstr Surg 1999;15:37–43.
Tabatabaee Z, Mazloumi M, Rajabi MT, et al. Comparison of the exposure rate of wrapped hydroxyapatite (Bio-Eye) versus unwrapped porous polyethylene (Medpor) orbital implants in enucleated patients. Ophthalmic Plast Reconstr Surg 2011;27:114–118.
Yoon JS, Lew H, Kim SJ, et al. Exposure rate of hydroxyapatite orbital implants a 15-year experience of 802 cases. Ophthalmology 2008;115:566–572.e2.
Jordan DR, Klapper SR, Gilberg SM. The use of vicryl mesh in 200 porous orbital implants: a technique with few exposures. Ophthalmic Plast Reconstr Surg 2003;19:53–61.
Shoamanesh A, Pang NK, Oestreicher JH. Complications of orbital implants: a review of 542 patients who have undergone orbital implantation and 275 subsequent PEG placements. Orbit 2007;26:173–182.
Jordan DR, Porous versus nonporous orbital Implants: a 25-year retrospective. Ophthalmology 2018;125:1317–1319.
Jordan DR, Parisi J. The scleral filet technique for secondary orbital implantation surgery. Can J Ophthalmol 1996;31:356–361.
Smit TJ, Koornneef L, Mourits MP, et al. Primary versus secondary intraorbital implants. Ophthalmic Plast Reconstr Surg 1990;6:115–118.
Sundelin KC, Dafgård Kopp EM. Complications associated with secondary orbital implantations. Acta Ophthalmol 2015;93:679–683.
Quaranta-Leoni FM, Sposato S, Lorenzano D. Secondary orbital ball implants after enucleation and evisceration: surgical management, morbidity, and long-term outcome. Ophthalmic Plast Reconstr Surg 2015;31:115–118.
Axmann S, Paridaens D. Anterior surface breakdown and implant extrusion following secondary alloplastic orbital implantation surgery. Acta Ophthalmol 2018;96:310–313.
Iliff CE. The extruded implant. Arch Ophthalmol 1967;78:742–744.
Toft PB, Rasmussen ML, Prause JU. One-stage explant-implant procedure of exposed porous orbital implants. Acta Ophthalmol 2012;90:210–214.
Curragh DS, Kamalarajah S, Lacey B, et al. Primary replacement for the management of exposed orbital implant. Orbit 2019;38:461–467.
Allen L. The argument against imbrication the rectus muscles over spherical orbital implants after enucleation. Ophthalmology 1983;90:1116–1120.
Jordan DR, Klapper SR. Evaluation and management of the anophthalmic socket and socket reconstruction. In: Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. Cham: Springer International Publishing, 2021:1068.
Viswanathan P, Sagoo MS, Olver JM. UK national survey of enucleation, evisceration and orbital implant trends. Br J Ophthalmol 2007;91:616–619.
Custer PL, Trinkaus KM, Fornoff J. Comparative motility of hydroxyapatite and alloplastic enucleation implants. Ophthalmology 1999;106:513–516.
Colen TP, Paridaens DA, Lemij HG, et al. Comparison of artificial eye amplitudes with acrylic and hydroxyapatite spherical enucleation implants. Ophthalmology 2000;107:1889–1894.