Scleral Eversion Technique for Porous Polyethylene Orbital Implant after Evisceration

ABSTRACT

PURPOSE: This study is to describe scleral eversion technique as a modification of evisceration to improve its disadvantages for placement of porous orbital implant and to report the results of placement of porous orbital implants with this technique. METHODS: The medical records of 27 patients with 27 eyes who had undergone evisceration and placement of porous polyethylene orbital implant with scleral eversion technique between November 1998 and January 2000 were reviewed. Surgical technique involved the removal of corneal button and the intraocular contents. Optic nerve was severed, scleral shell was everted, and porous polyethylene orbital implant was implanted into the retroscleral and intraconal space. RESULTS: Orbital implants of 20 mm in diameter were implanted in all patients. The average postoperative follow-up interval was 22.4 months. No patient experienced severe complications like exposure of implant. All of patients showed good motility of orbital implant and 19 patients were satisfied with motility of prosthesis. Eight patients (29.6%) got placement of motility coupling post without significant problems to enhance motility. CONCLUSIONS: Scleral eversion technique is safe and useful for evisceration and placement of porous polyethylene orbital implant. This technique can provide adequate space for adequate size of implant without any tension on wound, thick anterior scleral barrier for implant and more vascular source for fibrovascular ingrowth. Therefore, it decrease exposure rate of implant.