Extrusion rate of silicone spherical anophthalmic socket implants

Area of Science:

• Ophthalmology
• Surgical Techniques
• Ocular Prosthetics

Background:

• The traditional Frost-Lange technique for anophthalmic spherical implant placement, established in 1886, involves recti muscle imbrication and single-layer closure.
• This established method is associated with high extrusion rates (up to 11.3%), superotemporal implant migration, and suboptimal prosthetic motility.

Purpose of the Study:

• To introduce and evaluate a modified surgical technique for anophthalmic spherical implant placement.
• To assess the efficacy of the modified technique in reducing implant extrusion, migration, and improving prosthetic function compared to the Frost-Lange technique.

Main Methods:

• Modification involved independent suturing of recti muscles to a larger (20 mm) spherical implant, reinforced with autogenous fascia or preserved sclera.
• Independent, layered closure of Tenon's fascia and conjunctiva was performed.
• A retrospective study over 10 years evaluated outcomes in 119 patients.

Main Results:

• The modified technique demonstrated a significantly lower extrusion rate of 0.84% (1 of 119 patients).
• No instances of implant migration or painful sockets were observed in the study group.
• Prosthetic motility was reported as good following the modified surgical approach.

Conclusions:

• The modified surgical technique offers a substantial improvement over the traditional Frost-Lange method for anophthalmic spherical implant placement.
• This technique effectively minimizes complications such as implant extrusion and migration, leading to better functional and aesthetic outcomes.