Improved non-coupled prosthetic motility utilizing motility-enhancing fornix sutures

Orbit. 2009;28(1):37-42. doi: 10.1080/01676830802540832.

Abstract

Purpose: To evaluate the surgical technique and the motility of non-coupled ocular implant and prosthesis complex, utilizing fornix sutures, by examining the outcomes following evisceration surgery.

Materials and methods: Forty patients with atrophic, phthyiscal, or staphylomatous globes underwent evisceration using the scleral overlapping technique with a transequatorial release incision. All the patients were implanted with high-density porous polyethylene implants. Twenty patients underwent evisceration utilizing fornix sutures. The remaining 20 patients underwent a conventional described evisceration technique. Care was taken that no conjunctival shortening was present. Follow-up was for three months. The patients were all fitted by a non-coupled ocular prosthesis at one month and follow-up continued as usual.

Results: All cases showed functional improvement with an average increase of motility measurements when utilizing the motility-enhancing fornix sutures in comparison to the described conventional evisceration technique. Motility was measured by evaluating horizontal and vertical excursions. Results were documented up to three months postoperatively. Apart from a late postoperative exposure developing in one case, no cases of additional infection, extrusion, or granuloma formation were encountered.

Conclusion: The non-coupled prosthetic motility utilizing motility enhancing sutures was more predictable with superior motility effect over the conventional evisceration technique. However, a longer follow-up and perhaps a larger number of cases may be needed to provide additional support to the findings of this study.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Eye, Artificial*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orbit Evisceration / methods*
  • Polyethylene
  • Prosthesis Design
  • Prosthesis Implantation / methods*
  • Suture Techniques*
  • Treatment Outcome

Substances

  • Polyethylene