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Results for “Orbit Evisceration”

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At least 19 recordsLinked to original sources
PubMed2006

UK national survey of enucleation, evisceration and orbital implant trends.

AIM: To evaluate current clinical practice in the UK in the management of the anophthalmic socket; choice of enucleation, evisceration, type of orbital implant, wrap, motility pegging and complications. METHODS: All consultant ophthalmologists in the UK were surveyed by postal questionnaire. Questions included their practice subspecialty and number of enucleations and eviscerations performed in 2003. Specific questions addressed choice of implant, wrap, motility pegging and complications. RESULTS: 456/896 (51%) consultants responded, of which 162 (35%) had a specific interest in oculoplastics, lacrimal, orbits or oncology. Only 243/456 (53%) did enucleations or eviscerations. 92% inserted an orbital implant after primary enucleation, 69% after non-endophthalmitis evisceration, whereas only 43% did so after evisceration for endophthalmitis (50% as a delayed procedure). 55% used porous orbital implants (porous polyethylene, hydroxyapatite or alumina) as their first choice and 42% used acrylic. Most implants inserted were spherical, sized 18-20 mm in diameter. 57% wrapped the implant after enucleation, using salvaged autogenous sclera (20%), donor sclera (28%) and synthetic Vicryl or Mersilene mesh (42%). A minority (7%) placed motility pegs in selected cases, usually as a secondary procedure. 14% of respondents reported implant exposure for each type of procedure and extrusion was reported by 4% after enucleation and 3% after evisceration. CONCLUSIONS: This survey highlights contemporary anophthalmic socket practice in the UK. Most surgeons use porous orbital implants with a synthetic wrap after enucleation and only few perform motility pegging.

Consultants↗
PubMed1994

The role of pressure on regulation of craniofacial bone growth.

The regulatory role of pressure on growth and differentiation of the craniofacial skeleton is largely unknown. We devised an experimental model to determine if the graded application of pressure could exert a trophic influence on craniofacial bone, allowing deliberate alteration and reshaping of the facial skeleton. To examine this question, 18 kittens were used to determine the adverse morphological sequelae after orbital evisceration and to compare the ability to remedy such facial deformity with the use of an inert implant or pressure-induced tissue expansion. In addition to detailed craniometric measurements of the cranial, orbital, and midfacial regions, histological analyses as well as radiographic and gross morphological comparisons were evaluated. Our results demonstrate a severe asymmetry and constriction in the orbital and midfacial regions resulting from orbital evisceration in the growing kitten. Placement of an inert implant will help to ameliorate only some of these adverse sequelae, whereas graded application of pressure appears to direct craniofacial bone growth, resulting in normal bony histology and improved facial form. We affirm that regional growth disturbances can alter normal facial development and that the regulatory role of pressure on bone growth can be exploited to dynamically correct abnormal craniofacial anatomy.

Analysis of Variance↗
PubMed2004

[Modified evisceration for biocolonizable orbital implant: the four-square technique].

INTRODUCTION: The introduction of a porous, biocolonizable, orbital implant is difficult after a classic evisceration. We have developed a modification of the method that provides better results. MATERIAL AND METHODS: Four scleral squares pediculized on the right oculomotor muscles were cut. They were sutured two-by-two over the anterior part of the implant. RESULTS: Fifteen patients were operated. There were no complications during a mean follow-up of 12.4 months. DISCUSSION: The soft anterior tissues were protected by the two vascularized scleral layers. The diameter of the implant was 18 mm for three patients, 20 mm for eight patients, and 22 mm for four patients. Operating time was much shorter than with enucleation and covering of the implant with autologous sclera. CONCLUSION: Evisceration with the four-square technique is a safe and quick method, which can be used for most patients, except those with an intraocular neoplasia.

Adolescent↗
PubMedDate not supplied

Retroscleral implantation technique for porous polyethylene orbital implant after evisceration.

The authors developed a technique for the retroscleral implantation of a porous polyethylene orbital implant after evisceration for the placement of an adequately large orbital implant without wound tension. The surgical results of the technique in 27 patients are reported. The technique involves the severance of the optic nerve after standard evisceration and the insertion of the orbital implant into the retroscleral and intraconal space through the side of the scleral shell. All patients received a 20-mm orbital implant. No complications such as infection, implant exposure, or worsened implant motility were observed during the average follow-up period of 22.4 months. Retroscleral implantation of the orbital implant after evisceration may be an appropriate procedure that allows placement of a large orbital implant without exposure or decreased implant motility.

Adolescent↗
PubMed1985

Double sphere orbital implantation in enucleation and evisceration.

A simple technique of orbital implantation of two hollow spheres at enucleation or evisceration is described. The procedure sufficiently replaces lost volume in the enucleated or eviscerated orbit, facilitates prosthesis motility, and diminishes simulated enophthalmos and superior sulcus depression. The risk of implant migration or extrusion is not increased.

Eye Enucleation↗
PubMed2005

Multipurpose conical orbital implant in evisceration.

PURPOSE: To evaluate the safety and efficacy of the porous polyethylene multipurpose conical orbital implant for use in evisceration. METHODS: A retrospective review of 31 eyes that underwent evisceration and received the multipurpose conical orbital implant. The orbits were evaluated at 1 week, 1 month, and 6 months after final prosthetic fitting for implant exposure, superior sulcus deformity, and prosthetic motility. RESULTS: There were no cases of extrusion, migration, or infection. All patients had a good cosmetic result after final prosthetic fitting. Prosthetic motility was good in all patients. Exposure developed in one eye (3%) and a superior sulcus deformity developed in one eye (3%). CONCLUSIONS: Placement of an multipurpose conical orbital implant in conjunction with evisceration is a safe and effective treatment for blind painful eye that achieves good motility and a good cosmetic result.

Blindness↗
PubMed2003

Orbital metastasis from prostatic carcinoma.

A rare case of orbital metastasis from carcinoma of the prostate in a 76-year-old man who presented with pain in his left eye, mild proptosis and reduced visual acuity is reported. Cranial CT scanning demonstrated large bone metastases in the left orbit. The patient underwent orbital evisceration. The histopathological studies that were based on the morphological and immunohistochemical findings confirmed the histological diagnosis of orbital metastasis arising from prostatic carcinoma with neuroendocrine features.

Adenocarcinoma↗
PubMedDate not supplied

[Case of anaerobic infection in penetrating injury of the eye].

A patient with penetrating wound of the eye is described, whose wound has been contaminated with anaerobic infection. Clinical picture of anaerobic panophthalmitis has been rather typical, with the infection penetrating into soft tissues of the orbit. Evisceration of the eyeball was performed. Multiple-modality treatment was carried out. The infectious process has not progressed beyond the orbit. The diagnosis has been confirmed bacteriologically.

Bacteria, Anaerobic↗
PubMed2005

Secondary orbital implants after evisceration: a new conjunctiva-sparing technique.

PURPOSE: To describe a new conjunctiva-sparing technique for secondary orbital implantation after evisceration. METHODS: Two patients with conjunctival cicatrization and a volume-deficient anophthalmic socket had implantation of an intraconal biointegratable implant. This was placed through a lateral canthal approach, after temporary disinsertion of the lateral rectus, thereby avoiding further injury to the conjunctiva. RESULTS: A good surgical outcome was achieved in both patients. There were no intraoperative or postoperative complications, and both have remained stable for nearly 2 years. CONCLUSIONS: Secondary intraconal implantation through the lateral canthal approach is safe and effective and suitable for patients in whom it is desirable to avoid a conjunctival incision.

Adult↗
PubMed1998

Malignant rhabdoid tumor of the orbit.

A 36-month-old girl had a 3-week history of proptosis of the right eye. Computed tomography showed an ill-defined homogeneous mass filling the intraconal space. Histopathologic examination and immunohistochemistry findings of an incisional biopsy specimen were consistent with malignant undifferentiated tumor with rhabdoid features. Despite chemotherapy (a combination of vincristine sulfate and dactinomycin) and radiotherapy, massive orbital recurrence occurred 6 months later and orbital exenteration was performed. The recurrent tumor was composed entirely of pleomorphic epithelial cells with prominent nucleoli and many filamentous cytoplasmic inclusions. Immunohistochemical staining showed positive immunoreactivity for vimentin, cytokeratin, and epithelial membrane antigen, and negative immunoreactivity for muscle-specific antigen, melanoma, neural, and histiocytic markers. Electron microscopy excluded myogenic differentiation and showed that the filamentous cytoplasmic inclusions were composed of whorls of intermediate filaments. Aggressive chemotherapy with a combination of vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide phosphate was continued after exenteration. At 17 months' follow-up, orbital debulking surgery with externalization of the maxillary sinus was performed because of massive tumor recurrence in the right orbit and growth into the maxillary sinus. The child died 23 months after initial diagnosis from tumor invasion into the central nervous system. Extrarenal rhabdoid tumor is a rare orbital mass that carries a poor prognosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

Reconstruction with rectus abdominis myocutaneous free flap after orbital exenteration in children.

OBJECTIVE: To present a 1-stage technique for orbital reconstruction after exenteration with the use of myocutaneous rectus abdominis free flap in children. SURGICAL TECHNIQUE: After orbital exenteration, a myocutaneous rectus abdominis free flap with long vascular pedicle is harvested from the abdomen. The flap is transferred to the orbit and the vascular pedicle is passed through an opening made in the lateral orbital wall, where it is anastomosed to superficial temporal vessels. The skin of the flap is trimmed to correspond to the eyelid defect and the incisions are closed. METHODS: After informed consent was obtained, 2 children, 3 and 8 years old, underwent orbital reconstruction with a rectus abdominis free flap after exenteration for orbital rhabdomyosarcoma and orbital osteosarcoma in the setting of retinoblastoma. RESULTS: This technique allowed easy postoperative wound care. Viability of the flap was excellent. The technique provided sufficient volume to fill the orbit, with improved aesthetic results and minimal donor site deformity. CONCLUSIONS: The postoperative care and aesthetic outcome in patients with rectus abdominis free flap after exenteration are much improved over those provided with traditional surgical techniques. This primary reconstruction is recommended for any patient requiring orbital exenteration, but particularly for pediatric patients who tolerate debridement of traditional exenteration sites poorly.

Child↗