Extrusion rate of silicone spherical anophthalmic socket implants

The most popular technique of placement of an anophthalmic spherical implant was first described by Frost and Lange in 1886, and has remained essentially unchanged since that time. That technique incorporates imbrication of recti muscles over an 18 mm spherical implant, and purse stringing of conjunctiva and Tenon's fascia in a single layered closure. The Frost-Lange technique has led to previously reported extrusion rates as high as 11.3%. The technique is also associated with superotemporal implant migration and poor prosthetic motility. Our technique modification includes suturing recti muscles independently to a 20 mm spherical implant reinforced with autogenous fascia or preserved sclera. We then close Tenon's fascia and conjunctiva independently as separate layers. The extrusion rate for our patients during a 10 year study period was 0.84% (1 of 119). We found no implant migration, no painful socket, and prosthetic motility was good. We recommend our technique modification to replace the traditional Frost-Lange technique.