Current trends in managing the anophthalmic socket after primary enucleation and evisceration.
OBJECTIVE
To evaluate current trends in the management of the anophthalmic socket after primary enucleation and evisceration.


METHODS
The active membership of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) was surveyed regarding primary enucleations and eviscerations performed between January and December 2002. Survey questions included practice demographics, orbital implant use, wrapping materials, placement of a motility peg, reasons for implant choice, and complications encountered.


RESULTS
A total of 2,779 primary orbital implants were reported, comprising 1,919 (69.1%) enucleations and 860 (30.9%) eviscerations. The high-density porous polyethylene implant was used most frequently for enucleations (42.7%), followed by coralline hydroxyapatite (27.3%) and nonporous alloplastic implants (19.9%). For eviscerations, the high-density porous polyethylene implant was the most commonly used implant (42.3%), followed by hydroxyapatite (25.9%) and nonporous alloplastic implants (25.7%). The top 3 reasons for implant choice were outcome (69.3%), cost (43.6%), and experience (39.5%). Most implants were either not wrapped (59.8%) or were wrapped in donor sclera (25.2%) or polyglactin mesh (7.2%). Pegs were used in 8.1% of all implants reported. The most frequent complications encountered for unpegged implants were exposure (3.2%) and infection (0.4%). For pegged implants, the most common complications reported were pyogenic granuloma (13.7%), exposure (5.7%), and discharge (5.7%).


CONCLUSIONS
In managing the anophthalmic socket, ASOPRS survey respondents preferred to use the porous polyethylene implant after primary enucleation and evisceration. Most orbital implants were not wrapped, and most surgeons preferred not to place a motility post or peg in the implant.
Su
Grant W
GW
Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin, NC-536, Houston, TX 77030, U.S.A.
Yen
Michael T
MT
D000853:Anophthalmos / Q000601:surgery*; D020099:Coated Materials, Biocompatible; D017886:Durapatite; D015353:Eye Enucleation; D017234:Eye Evisceration; D006801:Humans; D007431:Intraoperative Complications; D013508:Ophthalmologic Surgical Procedures / Q000639:trends*; D009885:Ophthalmology / Q000639:trends; D009915:Orbit / Q000601:surgery*; D020273:Orbital Implants / Q000639:trends*; D020959:Polyethylene; D011183:Postoperative Complications; D010818:Practice Patterns, Physicians' / Q000639:trends
D020099:Coated Materials, Biocompatible; D020959:Polyethylene; D017886:Durapatite