Improved non-coupled prosthetic motility utilizing motility-enhancing fornix sutures

To evaluate the surgical technique and the motility of non-coupled ocular implant and prosthesis complex, utilizing fornix sutures, by examining the outcomes following evisceration surgery.

Forty patients with atrophic, phthyiscal, or staphylomatous globes underwent evisceration using the scleral overlapping technique with a transequatorial release incision. All the patients were implanted with high-density porous polyethylene implants. Twenty patients underwent evisceration utilizing fornix sutures. The remaining 20 patients underwent a conventional described evisceration technique. Care was taken that no conjunctival shortening was present. Follow-up was for three months. The patients were all fitted by a non-coupled ocular prosthesis at one month and follow-up continued as usual.

All cases showed functional improvement with an average increase of motility measurements when utilizing the motility-enhancing fornix sutures in comparison to the described conventional evisceration technique. Motility was measured by evaluating horizontal and vertical excursions. Results were documented up to three months postoperatively. Apart from a late postoperative exposure developing in one case, no cases of additional infection, extrusion, or granuloma formation were encountered.

The non-coupled prosthetic motility utilizing motility enhancing sutures was more predictable with superior motility effect over the conventional evisceration technique. However, a longer follow-up and perhaps a larger number of cases may be needed to provide additional support to the findings of this study.