Article Text

other Versions

PDF
UK National Survey of Enucleation, Evisceration and Orbital Implant Trends
  1. Palpandian Viswanathan (doctorvisu{at}hotmail.com),
  2. Mandeep S Sagoo,
  3. Jane M Olver (janeolver{at}aol.com)
  1. Royal Victoria Hospital, United Kingdom
  2. Moorfields Eye Hospital, United Kingdom
  3. Western Eye Hospital, United Kingdom

    Abstract

    Aims: To evaluate current clinical practice in the United Kingdom in the management of the anophthalmic socket; choice of enucleation, evisceration, type of orbital implant, wrap, motility pegging and complications.

    Methods: All Consultant Ophthalmologists in the UK were surveyed by postal questionnaire. Questions included their practice sub-specialty and number of enucleations and eviscerations performed in 2003. Specific questions addressed choice of implant, wrap, motility pegging and complications.

    Results: 456 / 896 (51%) Consultants responded, of which 162(35%) had a specific interest in oculoplastics, lacrimal, orbits or oncology. Only 243/456 (53%) did enucleations or eviscerations. 92% inserted an orbital implant after primary enucleation, 69% after non-endophthalmitis evisceration, whereas only 43% did so after evisceration for endophthalmitis (50% as a delayed procedure). 55% used porous orbital implants (porous polyethylene, hydroxyapatite, or alumina) as their first choice and 42% used acrylic. Most implants inserted were spherical, sized 18 to 20 mm diameter. 57% wrapped the implant after enucleation, using salvaged autogenous sclera(20%), donor sclera(28%) and synthetic Vicryl or Mersilene mesh(42%). A minority (7%) placed motility pegs in selected cases, usually as a secondary procedure. 14 % of respondents reported implant exposure for each type of procedure and extrusion was reported by 4 % after enucleation and 3 % after evisceration.

    Conclusions: This survey highlights contemporary anophthalmic socket practice in the UK. Most surgeons use porous orbital implants with a synthetic wrap following enucleation and only few perform motility pegging.

    • Enucleation
    • Evisceration
    • Orbital Implants
    • Pegging
    • Wrapping

    Statistics from Altmetric.com

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.