One-stage Intraconal Volume Modification for Exposed and Nonexposed Ball Implants

Area of Science:

• Ophthalmology
• Reconstructive Surgery

Background:

• Orbital implants are crucial for restoring ocular prosthesis aesthetics and function.
• Revisional surgery for exposed or nonexposed orbital implants presents challenges in achieving long-term success.
• Single-stage procedures aim to improve efficiency and patient recovery compared to traditional multi-stage approaches.

Purpose of the Study:

• To evaluate the long-term outcomes and reintervention rates of intraconal orbital implants after single-stage socket revision surgery.
• To compare outcomes of exposed versus nonexposed implants in single-stage revision procedures.
• To assess the efficacy of single-stage versus multi-stage revision surgery for orbital implants.

Main Methods:

• A retrospective review of 172 patients undergoing single-stage orbital implant revision.
• Group I: single-stage ball exchange (subdivided into exposed (A) and nonexposed (B) implants).
• Group II: single-stage ball removal with dermis-fat graft; outcomes compared to multi-stage surgery cohorts.

Main Results:

• Mean follow-up was 7.8 years.
• Nonexposed implants (Group IB) showed slightly higher reintervention rates for volume deficit (21%) and migration (6%) compared to exposed implants (Group IA).
• Exposed implants (Group IA) had a higher rate of re-exposures (7%); single-stage and multi-stage surgeries had similar reintervention rates.

Conclusions:

• Single-stage volume modification for orbital implants is effective, yielding results comparable to staged procedures.
• Patients generally achieve stable prostheses, satisfactory cosmesis, and faster rehabilitation.
• The study supports single-stage revision as a viable option for both exposed and nonexposed orbital implants.