Faculty Collaboration Database

Direct fixation of extraocular muscles to a silicone sphere: a cost-sensitive, low-risk enucleation procedure. Ophthalmic Plast Reconstr Surg 2011;27(5):364-7

Date

06/02/2011

Pubmed ID

21629135

DOI

10.1097/IOP.0b013e31821c1298

Scopus ID

2-s2.0-80052748272 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

PURPOSE: To describe a simple, cost-sensitive enucleation technique and to evaluate it in the context of intended benefits and long-term outcomes of alternate methods.

METHODS: A retrospective record review of patients who underwent enucleation using the described technique at a single institution by 2 surgeons. Surgery involved direct fixation of extraocular muscles to a solid silicone sphere, using nonabsorbable braided sutures with knots tied beneath the muscle insertions. Outcome measures included implant-related complications.

RESULTS: Seventy-five patients meeting inclusion criteria ranged in age from 3 to 94 years (mean, 54 years; median, 56 years). Surgical indications included a blind painful or disrupted eye in 56 cases; uveal melanoma in 15 cases; retinoblastoma in 2 cases; and endophthalmitis in 2 cases. Follow-up intervals ranged from 3 to 57 months (mean, 27 months; median, 22 months). Complications requiring surgical revision of the implant occurred in 2 of the 75 cases (one luxation; one exposure). There were no instances of chronic socket discharge or implant infection.

CONCLUSIONS: Nonabsorbable-suture attachment of muscles to a solid silicone implant offers an inexpensive enucleation option, with minimal risk of implant migration, exposure, or infection. In light of widespread disaffection with pegging of porous implants, and with no motility advantage of unpegged porous over nonporous implants, consideration should be given to techniques that are equally effective, less costly, and perhaps more reliable.

Author List

Wells TS, Harris GJ

Authors

Gerald J. Harris MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Timothy Scott Wells MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Eye Enucleation
Female
Humans
Male
Middle Aged
Oculomotor Muscles
Orbital Implants
Prosthesis Implantation
Retrospective Studies
Silicones
Suture Techniques
Young Adult