Enucleation with hydroxyapatite implantation versus evisceration plus scleral quadrisection and alloplastic implantation.
OBJECTIVE
To compare the motility and complications of enucleation with evisceration plus scleral quadrisection.


METHODS
In a prospective study between January 2006 and June 2007, 50 patients underwent evisceration with scleral quadrisection and alloplastic implantation (group 1) and 50 patients underwent enucleation and hydroxyapatite implantation (group 2). Horizontal and vertical excursions of implants and complications such as exposure or extrusion and deep superior sulcus deformity were evaluated postoperatively.


RESULTS
After a mean follow-up interval of 11.5 months for group 1 and 13.2 months for group 2, vertical measurements were approximately 20% less than horizontal measurements in both groups. The mean horizontal and vertical movements in group 2 were significantly less than in group 1 (p < 0.001). There was 1 case of small hydroxyapatite exposure in group 2 (1 in 50; 2%) and 2 cases of implant extrusion in group 1 (4%) (p = 0.50). Deep superior sulcus deformity was noted in 10 patients in group 1 (20%) and 7 patients in group 2 (14%) (p = 0.43). Analysis of covariance in both groups showed that age, gender, and follow-up interval were not predictors of movement in either direction (all p-values >0.05).


CONCLUSIONS
Evisceration with scleral quadrisection and alloplatic sphere implantation can effectively substitute for a more extensive procedure such as enucleation in patients with painful blind eyes, cosmetically unacceptable blind eyes, and medically uncontrolled endophthalmitis. It provides rapidity, ease, and better implant excursion and lower cost of the implants compared with their porous counterparts.
Tari
Ali Sadeghi
AS
Department of Ophthalmology, School of Medicine, Medical Sciences/Tehran University, Tehran, Iran.
Malihi
Mehrdad
M
Kasaee
Abolfazl
A
Tabatabaie
Syed Ziaeddin
SZ
Hamzedust
Khalil
K
Musavi
Mir Farnood
MF
Rajabi
Mohammad Taher
MT
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D017886:Durapatite; D015353:Eye Enucleation / Q000009:adverse effects; D017234:Eye Evisceration / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020273:Orbital Implants / Q000009:adverse effects; D011446:Prospective Studies; D019919:Prosthesis Implantation; D012590:Sclera / Q000601:surgery*
D001672:Biocompatible Materials; D017886:Durapatite