Related Experiment Video
Updated: Aug 9, 2026
Adult and Pediatric Porcine Model of Acute Volume Overload
Published on: January 12, 2024
Pediatric enucleation: analysis of volume replacement
S A Kaltreider1, L R Peake, B T Carter
1Department of Ophthalmology, University of Virginia Health System, Box 800715, Charlottesville, VA 22908-0715, USA. sak5m@virginia.edu
Insights
Adequate implant volume replacement in pediatric patients undergoing enucleation is crucial. Proper initial implant sizing can prevent long-term socket deformities and the need for secondary surgeries in adulthood.
Area of Science:
- Ophthalmic surgery
- Orbital implants
- Pediatric ophthalmology
Background:
- Enucleation is the surgical removal of the eyeball.
- Post-enucleation socket syndrome can lead to cosmetic and functional deficits.
- Volume replacement with orbital implants is critical for optimal outcomes.
Purpose of the Study:
- To assess implant volume replacement in pediatric vs. adult enucleation patients.
- To evaluate long-term sequelae of inadequate volume replacement.
- To establish guidelines for pediatric orbital implant volume replacement.
Main Methods:
- Retrospective observational study of 16 pediatric and 31 adult patients enucleated in childhood.
- Determination of total and implant volume replacement.
- Assessment of secondary surgeries for socket deformities (superior sulcus deformity, enophthalmos, ptosis, ectropion, socket contraction).
Main Results:
- Average implant volume replacement was 68% in pediatric patients (group 1) and 21% in adults enucleated in childhood (group 2).
- 71% of group 2 patients required secondary surgery for volume augmentation and deformity correction.
- Inadequate initial volume replacement correlates with long-term socket complications.
Conclusions:
- Appropriate initial implant sizing in pediatric enucleation can prevent adult socket deformities.
- The study suggests an implant diameter 2 mm less than the eye's axial length for pediatric patients.
- Optimizing primary implant volume replacement is key to avoiding secondary reconstructive surgeries.
Objectives:
To determine the percent volume replacement by an implant and prosthesis, the long-term sequelae of poor volume replacement, and specific guidelines for volume replacement in pediatric patients.
Methods:
A retrospective observational study of 16 pediatric patients who underwent enucleation (group 1) and 31 adult patients enucleated in childhood (group 2) was performed. The total volume replacement and the volume replacement by the implant were determined. The incidence of secondary surgical procedures for superior sulcus deformity, enophthalmos, ptosis, ectropion, and socket contraction was determined.
Results:
The average percent volume replaced by the implants in group 1 patients was 68%. The average percent volume replaced by the implants in group 2 patients was 21%. Seventy-one percent of patients in group 2 underwent secondary implant surgery to augment volume and eliminate superior sulcus deformity and enophthalmos.
Conclusions:
The placement of an adequately sized implant in pediatric patients may obviate the need for secondary augmentation of socket volume in adulthood. The authors suggest an implant 2 mm less in diameter than the axial length of the eye in pediatric patients.
