[Method of implant insertion in anophthalmic socket]

Area of Science:

• Ophthalmology
• Surgical Techniques
• Ocular Prosthetics

Background:

• Eye enucleation necessitates prosthetic rehabilitation to maintain ocular function and aesthetics.
• Restoring stump motility after enucleation is crucial for prosthetic comfort and appearance.
• Existing methods may have limitations, particularly in patients with prior radiation therapy.

Purpose of the Study:

• To describe and evaluate a direct extraocular muscle fixation method to an allplant for improved stump movement post-enucleation.
• To assess the technical feasibility and outcomes of this technique in a diverse patient cohort.
• To identify potential challenges and compare outcomes in primary enucleation versus post-brachytherapy cases.

Main Methods:

• A microsurgical technique involving direct fixation of extraocular muscles to an allplant was employed in 54 patients.
• Muscles were attached according to their physiological insertion points on the allplant.
• Specific suturing techniques for the allplant to the tenon's capsule and conjunctiva were utilized, followed by a pressure dressing.

Main Results:

• The described fixation method was generally technically straightforward, facilitating stump movement.
• No major technical difficulties were encountered in patients undergoing primary enucleation.
• Scarring from prior brachytherapy complicated muscle and tenon's capsule separation in 8 patients.

Conclusions:

• Direct extraocular muscle fixation to an allplant is a viable technique for restoring stump motility after enucleation.
• The method is effective in primary enucleation cases, with potential challenges in patients with prior radiation therapy.
• Further research may explore modifications for irradiated tissues to optimize outcomes.