A modified evisceration technique with scleral quadrisection and porous polyethylene implantation

Am J Ophthalmol. 2009 May;147(5):924-8, 928.e1-3. doi: 10.1016/j.ajo.2008.11.022. Epub 2009 Feb 10.

Abstract

Purpose: To propose and evaluate a modified evisceration technique that aiming to minimize the extrusion or exposure and improve motility of the implant.

Design: Interventional prospective study.

Methods: There were 154 patients referred to our clinic from March 1, 2003 to March 1, 2007. All the patients underwent the primary evisceration and implantation of a porous polyethylene implant using the modified technique, which included quadrisecting the sclera, suturing the implant with each rectus muscle through the scleral petal, and then covering the implant with 2 layers of the sclera. Main outcome measures were complications such as conjunctival dehiscence, implant extrusion, implant exposure, significant enophthalmos, superior sulcus deformity or orbital cellulitis, and cosmetic outcome.

Results: All patients received porous polyethylene implants with 18 mm or larger sphere. In a mean 3.5 years follow-up period (range, 1 to 5 years), there was no case of conjunctival dehiscence, implant extrusion, implant exposure, significant enophthalmos, superior sulcus deformity, or orbital cellulitis. The cosmetic appearance and implant mobility were satisfactory.

Conclusions: This technique appears to be an excellent modification for anophthalmic socket reconstruction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biocompatible Materials*
  • Child
  • Eye Evisceration / methods*
  • Eye, Artificial
  • Female
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Orbital Implants*
  • Plastic Surgery Procedures
  • Polyethylenes*
  • Porosity
  • Postoperative Complications
  • Prospective Studies
  • Prosthesis Implantation
  • Sclera / surgery*
  • Young Adult

Substances

  • Biocompatible Materials
  • Medpor
  • Polyethylenes