RT Journal Article
SR Electronic
T1 Outcomes of enucleation and porous polyethylene orbital implant insertion in patients with paediatric retinoblastoma: a long-term follow-up study
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 502
OP 509
DO 10.1136/bjophthalmol-2020-317934
VO 106
IS 4
A1 Min Kyu Yang
A1 Min Joung Lee
A1 Namju Kim
A1 Hokyung Choung
A1 Sang In Khwarg
YR 2022
UL http://bjo.bmj.com/content/106/4/502.abstract
AB Background/Aims To report the long-term outcomes of enucleation and insertion of porous polyethylene (PP) orbital implant according to the evolving surgical techniques and implant in patients with paediatric retinoblastoma .Methods Patients with paediatric retinoblastoma who underwent enucleation and PP implant insertion from December 1998 to December 2014 were retrospectively reviewed and divided into four groups: group A, classic enucleation +PP implant; group B, enucleation +PP implant +anterior closure of the posterior Tenon’s (ACPT) capsule; group C, enucleation +PP implant +free orbital fat graft +ACPT and group D, enucleation +smooth surface tunnel PP implant +ACPT. Survival analysis of implant exposure and eyelid malpositions was performed.Results One hundred and ninety-eight eyes of 196 patients were included. The median follow-up period was 13.0 years (range, 5.0–21.1). A 20 mm implant was inserted for 149 eyes (75.3%). The 10-year exposure-free survival probabilities were 44.6% in group A, 96.4% in group B, 97.4% in group C and 97.7% in group D. ACPT was associated with significant reduction in implant exposure (p<0.001). The most common eyelid malposition was upper eyelid ptosis (24.2%). The eyelid malposition-free survival probability did not differ among the four groups. However, the insertion of a 20 mm implant was associated with significant reduction in upper eyelid ptosis and lower eyelid entropion (p=0.004 and 0.038, respectively).Conclusions The long-term postenucleation implant exposure was rare after PP implant insertion and ACPT, even with a 20 mm-diameter implant. A larger implant can be beneficial in long-term prevention of eyelid malposition.Data are available upon reasonable request. Our deidentified participant data are available upon reasonable request. Contact ORCID: 0000-0001-5740-1639.