J.ophthalmol.(Ukraine).2021;2:30-36.
http://doi.org/10.31288/oftalmolzh202253036
Received: 07.09.2022; Accepted: 06.10.2022; Published on-line: 27.10.2022
A novel technique of evisceration or enucleation secondary to trauma, chronic uveitis or uveal melanoma, with permanent and removable fixation of the ocular prosthesis in a musculoskeletal stump
A. P. Maletskyi 1, N. M. Bigun 2
1 SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine); Odesa (Ukraine)
2 Lviv Regional Clinical Hospital; Lviv (Ukraine)
TO CITE THIS ARTICLE: Maletskyi AP, Bigun NM. A novel technique of evisceration or enucleation secondary to trauma, chronic uveitis or uveal melanoma, with permanent and removable fixation of the ocular prosthesis in a musculoskeletal stump. J.ophthalmol.(Ukraine).2022;5:30-6. http://doi.org/10.31288/oftalmolzh202253036
Background: The state and motility of a cosmetic ocular prosthesis are important.
Purpose: To develop a novel technique of evisceration or enucleation secondary to trauma, chronic uveitis or uveal melanoma, with permanent and removable fixation of the ocular prosthesis in a musculoskeletal stump (MS).
Material and Methods: Group 1 comprised 52 patients with chronic uveitis secondary to trauma and phthisis bulbi who underwent evisceration. After evisceration, a polymer composite implant or a polytetrafluoroethylene (PTFE) implant was used to shape an MS with a hole in it for the pegged prosthesis, and the prosthesis motility in these patients was compared with that in the 13 controls in whom an MS without a hole in it for the pegged prosthesis was shaped. Group 2 comprised 31 patients with uveal melanoma who underwent enucleation with a PTFE implant used to shape an MS with a hole in it. The prosthesis motility in these patients was measured and compared with that in the 100 controls in whom an MS without a hole in it for the pegged prosthesis was shaped.
Results: In patients of group 1, total prosthesis motility at 3 and 12 months improved to 132.50 ± 6.40 and 147.30 ± 6.70, respectively, versus 103.70 ± 18.30 and 103.10 ± 6.00, respectively, in the controls. No implant exposure was observed over the follow-up period. In three patients of group 2, diastasis of the conjunctival margins with implant exposure was observed at the margin of the hole at months 3 and 7, which necessitated implant removal. In patients of group 2, total prosthesis motility in the four meridians at 3 and 12 months was 141.60 ± 14.70 and 142.20 ± 16.10, respectively, versus 106.10 ± 13.00 and 103.70 ± 18.30, respectively, in the controls.
Conclusion: We found that firm fixation of the pegged ocular prosthesis in the MS allowed improving total prosthesis motility in the four meridians at 3 months and 12 months after evisceration, by 28.8о and 44.2о, respectively, and at 3 months and 12 months after enucleation, by 35.5о and 38.5о, respectively.
Keywords: PTFE implants, polymer composite implants, musculoskeletal stump, trauma, uveitis, uveal melanoma
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Disclosures
Corresponding Author: Maletskyi A. P., Email: maletskiy@filatov.com.ua
Author Contributions: Maletskyy AP: Conceptualization, Project administration, Data Curation, Writing – original draft, Writing – review & editing
Bigun NM: Data Curation, Writing – original draft, Writing – review & editing
All authors reviewed the results and approved the final version of the manuscript.
Funding sources: The study is a portion of the Development of Novel Synthetic Polymer Implants with Immobilized Biologically Active Substances and Assessment of Tissue Response at the Orbital and Periorbital Area, a research program.
Conflict of interest: The authors state that they have no conflict of interest that might bias this work.
The study was conducted in the clinical setting. Ethical standards were adhered to throughout the study