Outcomes and complications of evisceration with primary implant: an electronic medical record driven analytics of 1800 cases.

Abstract

PURPOSE:

To describe the surgical outcomes and implant complications in 1,800 patients undergoing evisceration with primary implant.

METHODS:

An Electronic Medical Record-driven analysis of 1,800 patients undergoing evisceration with primary implant between 2013 and 2019. Implant sizing was performed intra-operatively to place the largest implant without tension on the wound closure. Outcome measures included implant complications, prosthesis measurements, and incidence of a good aesthetic outcome. Good outcome was defined as <2 mm enophthalmos and grade 1 or less superior sulcus deformity with a custom ocular prosthesis.

RESULTS:

Eighteen hundred eyes of 1800 patients were included. The mean age at surgery was 36 ± 21 years (median 32 years). Implants used were poly(methyl methacrylate) (PMMA) in 1737 (97%) and porous polyethylene in 63 (3%) patients. Two-petal sclerotomy was performed in 1512 (88%) and four-petal sclerotomy in 165 (10%) patients. The mean diameter of the implant used was 19.35 ± 1.18 mm (median 20, range 10-22 mm). The implant extrusion rate was 3% (56) and implant displacement was seen in none. The mean prosthesis volume and thickness were 2.22 ± 0.67 ml (median 2, range 1-6.5 ml) and 6 ± 1 mm (median 6, range 2-9 mm). The mean difference in prosthesis projection on Hertel's exophthalmometer was 0.28 ± 1 mm (median 0, range 0-1 mm). Good outcome was observed in 93%. The mean follow-up period was 351 ± 386 days (median 194).

CONCLUSION:

Evisceration with empirically selected primary orbital implant placement is associated with minimal implant complications and gives a good aesthetic outcome in 93% of the patients.

• Authors: Tarjani Vivek Dave, Anthony Vipin Das, Sameer Mohapatra, Oshin Bansal, Anasua Ganguly
• Journal: Orbit (Amsterdam, Netherlands) (Orbit) Vol. 41 Issue 6 Pg. 717-725 (Dec 2022) ISSN: 1744-5108 [Electronic] England
• PMID: 34783616 (Publication Type: Journal Article)

Chemical References

• Polyethylene
• Polymethyl Methacrylate

Topics

• Humans
• Adolescent
• Young Adult
• Adult
• Middle Aged
• Eye Evisceration
• Orbital Implants
• Electronic Health Records
• Retrospective Studies
• Prosthesis Implantation (adverse effects)
• Polyethylene
• Postoperative Complications (etiology)
• Polymethyl Methacrylate
• Eye Enucleation