Consideration for eliminating conjunctival closure in the enucleation procedure

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Ocular Prosthetics

Background:

• Enucleation surgery, the removal of an eye, requires careful post-operative management to ensure optimal outcomes.
• The method of conjunctival closure following enucleation, specifically whether to suture it directly, is a point of clinical consideration.
• Understanding the impact of conjunctival closure on complications and surgical efficiency is crucial for patient care.

Purpose of the Study:

• To compare post-operative results and complications in patients undergoing enucleation with or without direct conjunctival suture closure.
• To evaluate the incidence of implant extrusion, exposure, infection, and conjunctival cyst formation between the two surgical techniques.

Main Methods:

• Retrospective chart review of 50 enucleation cases between July 2011 and December 2014.
• Inclusion criteria: enucleation with extraocular muscles attached to a spherical orbital implant, with or without conjunctival closure, and at least 2 months of follow-up.
• Cases were divided into two groups: direct conjunctival closure (12 cases) and no direct conjunctival closure (24 cases).

Main Results:

• No implant complications (extrusion, exposure, infection) were identified in either group (p = 1.0).
• Two cases in the conjunctival closure group developed conjunctival cysts, compared to none in the non-closure group (p = 0.1048).
• Mean follow-up was 16.71 months; non-closure group follow-up averaged 14.42 months.

Conclusions:

• Direct conjunctival closure following enucleation surgery does not appear to increase the risk of implant extrusion, exposure, or infection.
• Foregoing direct conjunctival closure may decrease surgical time and reduce costs.
• The effect of direct conjunctival closure on conjunctival cyst formation requires further investigation.