APPLICATION OF ORBITAL IMPLANTS IN ORBITAL IMPLANTATION AFTER EVISCERATION IN CHILDREN: CURRENT CONCEPTS AND CLINICAL PERSPECTIVES
DOI:
https://doi.org/10.17605/Keywords:
Evisceration, enucleation, orbital implants, polytetrafluoroethylene, anophthalmos, buphthalmos, children, orbital stump, ocular prosthetics, ophthalmic surgeryAbstract
Removal of the eye in childhood requires not only elimination of the pathological process but also comprehensive anatomical and functional rehabilitation of the patient. At present, evisceration with primary orbital implantation is considered one of the most effective methods for the formation of a functional orbital stump after eye removal.
This review article presents current data on the use of orbital implants in children following evisceration. The paper discusses the main advantages of evisceration compared with enucleation, the specific features of stump formation in pediatric patients, and modern materials used for orbital implantation. Particular attention has been focused on polytetrafluoroethylene (PTFE) implants, which demonstrate high biocompatibility, stable volume maintenance, and a low rate of postoperative complications.
The article also analyzes the outcomes of modified evisceration techniques for buphthalmos using combined orbital implants, which allow compensation for orbital volume deficiency and reduce the risk of postanophthalmic enophthalmos. In addition, the major complications of orbital implantation and the factors influencing implant exposure are reviewed.
Modern approaches to reconstructive ophthalmic surgery suggest that eye removal in children should be regarded not as the final stage of treatment, but as the beginning of comprehensive functional and cosmetic rehabilitation.
References
1. Gundorova R.A., Bykov V.P., Kataev M.G., Filatova I.A. New achievements in orbital implantology and ocular prosthetics. Rossiyskiy meditsinskiy zhurnal. 2000;6:27–30.
2. Kataev M.G., Filatova I.A. Method for formation of a postenucleation stump. Russian Federation Patent No. 2105535; registered 27.02.1998.
3. Filatova I.A. Anophthalmos. Pathology and Treatment. Moscow: IP Stepanov; 2007. 213 p.
4. Filatova I.A., Mokhammad I.M. Modified evisceration technique for buphthalmos using combined orbital implants. Russian Pediatric Ophthalmology. 2017;12(4):210–215.
5. Filatova I.A., Shemetov S.A., Mokhammad I.M., Kondrateva Yu.P. Long-term experience with polytetrafluoroethylene orbital implants. Ophthalmology in Russia. 2024;21(1):91–99.
6. Al-Farsi H.A., Sabt B.I., Al-Mujaini A.S. Exposure of orbital implant after enucleation or evisceration. Oman Journal of Ophthalmology. 2017;10(2):87–90.
7. Custer P.L., Kennedy R.H., Woog J.J., Kaltreider S.A., Meyer D.R. Orbital implants in enucleation surgery: a report by the American Academy of Ophthalmology. Ophthalmology. 2003;110:2054–2061.
8. Dortzbach R.K., Woog J.J. Choice of procedure: enucleation, evisceration or prosthetic fitting over globes. Ophthalmology. 1985;92:1249–1255.
9. Holds J.B., Chang W.J., Durairaj V.D., Foster J.A., Gausas R.E., Harrison A.R. Basic and Clinical Science Course: Orbit, Eyelids, and Lacrimal System. San Francisco: American Academy of Ophthalmology; 2014–2015:121–122.
10. Mahoney N.R., Grant M.P., Iliff N.T., Merbs S.L. Exposure rate of smooth surface tunnel porous polyethylene implants after enucleation. Ophthalmic Plastic and Reconstructive Surgery. 2014;30:492–498.
11. McCord C.D. Jr., Tanenbaum M., Nunery W.R., Chen W.P.D. Enucleation, evisceration and exenteration. In: Oculoplastic Surgery. 3rd ed. New York: Raven Press; 1995.
12. Nolan L.M., O'Keefe M., Lanigan B. Hydroxyapatite orbital implant exposure in children. Journal of AAPOS. 2003;7:345–348.
13. Schellini S.I., Jorge E.L., Sousa R.O., Burroughs J.O., El-Dib R.E. Porous and nonporous orbital implants for treating anophthalmic socket: a meta-analysis of case series studies. International Journal of Orbital Disorders, Oculoplastic and Lacrimal Surgery. 2016;35:78–86.
14. Shah-Desai S.D., Tyers A.G., Manners R.M. Painful blind eye: efficacy of enucleation and evisceration in resolving ocular pain. British Journal of Ophthalmology. 2000;84:437–438.
15. Wang J.K., Liao S.L., Lai P.C., Lin L.L. Prevention of exposure of porous orbital implants following enucleation. American Journal of Ophthalmology. 2007;143:61–67.
16. Ye J., Gao Q., He J.J., Gao T., Ning Q.Y., Xie J.J. Exposure rate of unwrapped hydroxyapatite orbital implants in enucleation surgery. British Journal of Ophthalmology. 2016;100:860–865.
17. Yoon J.S., Lew H., Kim S.J., Lee S.Y. Exposure rate of hydroxyapatite orbital implants. Ophthalmology. 2008;115:566–572.
