A Single- Versus Double-Layered Closure Technique in Anophthalmic Surgery.
OBJECTIVE
To compare the frequency of orbital implant exposure and extrusion following eye removal with a simplified closure technique, closing Tenon's capsule and conjunctiva in 1 layer versus the classic technique of closure in 2 separate layers.


METHODS
The authors conducted a retrospective case note review of patients who underwent evisceration or enucleation treated by 1 surgeon between 2001 and 2013. Between 2001 and 2004, Tenon's capsule and conjunctiva were closed in separate layers; after 2004, a simplified 1-layer closure following eye removal was used. The primary outcome parameters were presence or absence of implant exposure or extrusion.


RESULTS
One hundred fifty-seven patients who underwent evisceration and 172 patients who underwent enucleation were included. Following evisceration, 2.5% developed exposure or extrusion of the implant, this was 2.5% in the 1-layer closure technique and 2.7% in the 2-layer closure technique (p = 0.95). Following enucleation, 1.7% developed exposure or extrusion of the implant, this was 1.8% in the 1-layer closure technique and 1.7% in the 2-layer closure technique (p = 0.96). Overall implant exposure and extrusion was 2.1%, this was 2.2% in the 1-layer closure technique and 2.1% in the 2-layer closure technique (p = 0.96).


CONCLUSIONS
No difference was found in the frequency of spheric acrylic implant exposure or extrusion in patients who underwent eye removal with single-layer closure of Tenon's capsule and conjunctiva compared with patients treated with separate closure of these layers.
*The Rotterdam Eye Hospital, Rotterdam, †St. Antonius Hospital, Nieuwegein, and ‡Erasmus University Medical Centre, Rotterdam, The Netherlands.
Jennifer S N
JSN
Verhoekx
Anina
A
Rengifo Coolman
Win Hou Willy
WHW
Tse
Dion
D
Paridaens
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000853:Anophthalmos / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000601:surgery*; D020273:Orbital Implants; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D055815:Young Adult