Korean J Ophthalmol.  2010 Oct;24(5):279-283. 10.3341/kjo.2010.24.5.279.

The Results of Evisceration with Primary Porous Implant Placement in Patients with Endophthalmitis

Affiliations
  • 1Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea. yswoph@catholic.ac.kr

Abstract

PURPOSE
To assess the results and long-term prognosis of evisceration with primary porous implant placement in patients with endophthalmitis.
METHODS
A retrospective study was conducted to review the files of 27 patients (29 eyes) with endophthalmitis who underwent evisceration with primary porous implant placement from January 1997 to December 2007 at St. Mary's Hospital and Kangnam St. Mary's Hospital. The mean follow-up period was 12.24 months (range, 3 to 89 months) and the mean age of the patients was 63.6 years (range, 33 to 89 years).
RESULTS
During the surgical procedure, primary implant placement was successfully completed, and any postoperative infection or inflammation rapidly resolved in all 27 patients (29 eyes). One of two porous implant materials was used. Hydroxyapatite was inserted in 14 eyes and Medpor was inserted in 15 eyes. Delayed implant exposure was noted in 1 eye, which was treated by inserting a hydroxyapatite implant 18 months after the first surgery. This was well treated by a preserved scleral graft. Implant infection was noted in 1 other eye at 20 days after the first surgery. All other minor complications healed without sequelae.
CONCLUSIONS
Evisceration with primary porous implant placement as the treatment for recalcitrant endophthalmitis resulted in rapid resolution of any infection and inflammation. Implant exposure and infection occurred in only 2 eyes, and these problems were well treated without long-term sequelae. Therefore, evisceration with primary porous implant placement is a treatment option for patients with endophthalmitis.

Keyword

Endophthalmitis; Evisceration; Porous implant

MeSH Terms

Adult
Aged
Aged, 80 and over
Endophthalmitis/microbiology/*surgery
*Eye Evisceration
Female
Humans
Male
Middle Aged
*Orbital Implants
Porosity
Prognosis
Retrospective Studies
Treatment Outcome

Cited by  1 articles

Comparison of Evisceration with Primary Orbital Implant Surgery in Endophthalmitis and Phthisis Bulbi
Jae Ho Jung, Jong Heon Lee, Hye Shin Jeon, Hee Young Choi
J Korean Ophthalmol Soc. 2014;55(7):958-962.    doi: 10.3341/jkos.2014.55.7.958.


Reference

1. O'Donnell BA, Kersten R, McNab A, et al. Enucleation versus evisceration. Clin Experiment Ophthalmol. 2005. 33:5–9.
2. Viswanathan P, Sagoo MS, Olver JM. UK national survey of enucleation, evisceration and orbital implant trends. Br J Ophthalmol. 2007. 91:616–619.
3. Abel AD, Meyer DR. Enucleation with primary implant insertion for treatment of recalcitrant endophthalmitis and panophthalmitis. Ophthal Plast Reconstr Surg. 2005. 21:220–226.
4. Remulla HD, Rubin PA, Shore JW, et al. Complications of porous spherical orbital implants. Ophthalmology. 1995. 102:586–593.
5. Blaydon SM, Shepler TR, Neuhaus RW, et al. The porous polyethylene (Medpor) spherical orbital implant: a retrospective study of 136 cases. Ophthal Plast Reconstr Surg. 2003. 19:364–371.
6. Tawfik HA, Budin H. Evisceration with primary implant placement in patients with endophthalmitis. Ophthalmology. 2007. 114:1100–1103.
7. Dresner SC, Karesh JW. Primary implant placement with evisceration in patients with endophthalmitis. Ophthalmology. 2000. 107:1661–1664.
8. Merritt K, Shafer JW, Brown SA. Implant site infection rates with porous and dense materials. J Biomed Mater Res. 1979. 13:101–108.
9. Sun DY, Kim YD. Management of exposed porous orbital implants. J Korean Ophthalmol Soc. 2004. 45:1409–1419.
10. Kim JY, Wang SJ, Park CJ, Lee SB. Risk factors leading to enucleation or evisceration in endophthalmitis. J Korean Ophthalmol Soc. 2007. 48:1362–1368.
11. Kim DS, Kim SH, Yoon IH. Exposure incidence of porous orbital implants. J Korean Ophthalmol Soc. 2003. 44:2711–2719.
12. Migliori ME. Enucleation versus evisceration. Curr Opin Ophthalmol. 2002. 13:298–302.
13. Burnstine MA. Primary implant placement with evisceration. Ophthalmology. 2000. 107:1664–1665.
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