Four Petal Evisceration: Pros and Cons | ||||
The Egyptian Journal of Hospital Medicine | ||||
Article 12, Volume 69, Issue 4, October 2017, Page 2250-2253 PDF (311.59 K) | ||||
Document Type: Original Article | ||||
DOI: 10.12816/0041525 | ||||
View on SCiNiTO | ||||
Authors | ||||
Rehab M. Kamel1; Doaa A. Mahmoud1; Ahmed M. Amin2 | ||||
1Department of Ophthalmology, Al-Azhar University University, Faculty of Medicine for Girls, | ||||
2Department of Ophthalmology, Al-Azhar University University, Faculty of Medicine for Boys | ||||
Abstract | ||||
purpose: To evaluate four petals evisceration as one of the best modifications in evisceration surgery, allowing the use of large orbital implant with low incidence of complications. Methods: We conducted a retrospective, interventional study on evisceration with placement of spherical non porous orbital implant after four petal evisceration. Preoperative examination included full history, ophthalmological examination, indication for surgery, B-scan ultrasonography, axial length in cases of atrophic and socket surface in secondary cases. All patients were operated a four petal evisceration with spherical non porous implant of size 18 to 22. Postoperative, all patients were followed for at least 6 months for presence of complications, implant and prosthesis motility and the final cosmetic results. Results: 18 eyes were included. Diagnosis necessitating evisceration was atrophia bulbi in 8 patients, endophthalmitis in 2 patients, and implant exposure in 4 patients, corneoscleral melting due to caustic exposure in 1 patient, self-eviscerated globe due to severe trauma in 1 patient and anopthalmic socket following evisceration without implant in 2 patients. Implant size was 18 in 1 patient, 20 in 6 patients, and 22 in 11 patients. No implant exposure occurred; superior sulcus deformity occurred in 3 patients, downward implant migration occurred in 1 patient. Regarding implant motility, it was good with mean of 75% in 14 patients; moderate with mean of 66% in 4 patients. The prosthesis motility was fair with mean of 35% in 12 patients (66.6%) and poor with mean (10%) in 6 patients. Conclusion: Four petals evisceration facilitates the use of large sized implant in all cases even in implant exposure with deficient sclera with good post-operative final cosmetic results, very low rate of complications and moderate prosthesis motility. | ||||
Keywords | ||||
four petal evisceration; Implant exposure; atrophia | ||||
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