Surgical outcomes of orbital evisceration with primary orbital implant placement in patients with endophthalmitis.

Autor: Lai KKH; Department of Ophthalmology, Tung Wah Eastern Hospital Causeway Bay, Hong Kong, Hong Kong. 612khlai@gmail.com., Au AKH; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital Sha Tin, Hong Kong, Hong Kong., Kuk AKT; Department of Ophthalmology, Tung Wah Eastern Hospital Causeway Bay, Hong Kong, Hong Kong., Tsang A; Department of Ophthalmology, Tung Wah Eastern Hospital Causeway Bay, Hong Kong, Hong Kong., Tai JHC; Department of Ophthalmology, Tung Wah Eastern Hospital Causeway Bay, Hong Kong, Hong Kong., Wang T; Department of Ophthalmology, Tung Wah Eastern Hospital Causeway Bay, Hong Kong, Hong Kong., Ko STC; Department of Ophthalmology, Tung Wah Eastern Hospital Causeway Bay, Hong Kong, Hong Kong., Chan E; Department of Ophthalmology, Tung Wah Eastern Hospital Causeway Bay, Hong Kong, Hong Kong., Ko CKL; Department of Ophthalmology, Tung Wah Eastern Hospital Causeway Bay, Hong Kong, Hong Kong.
Jazyk: angličtina
Zdroj: Eye (London, England) [Eye (Lond)] 2023 May; Vol. 37 (7), pp. 1361-1364. Date of Electronic Publication: 2022 Jun 23.
DOI: 10.1038/s41433-022-02135-x
Abstrakt: Objectives: This study reports the surgical outcomes of evisceration with primary orbital implant placement in patients with endophthalmitis and analyses the association with implant exposure and extrusion.
Methods: A retrospective, multicentre, Chinese cohort study. Review of medical records and orbital images of patients who underwent evisceration with primary orbital implant placement between January 2005 and January 2021.
Results: Out of 79 patients who underwent orbital evisceration with primary orbital implant placement, 26 (26 eyes) of them (male = 13) suffered from endophthalmitis. The duration from endophthalmitis diagnosis (19 = exogenous, 7 = endogenous) to evisceration was 9 standard deviation ± 5 (range: 1-15) days. The follow-up was 70 ± 46 (24-180) months after operation. The orbital implant size was 17 ± 3 (14-20) mm, and silicone was the most used material (69%, 18/26 of patients). The most frequent post-operative complication was orbital implant exposure (42%, 11/26), followed by orbital implant extrusion (12% 3/26) and ptosis (8%, 2/26). Implant exposure or extrusion was more commonly associated with endophthalmitis in comparison to non-endophthalmitis patients that required evisceration and primary orbital implant placement (54% versus 17%, P < 0.05). Univariate analysis showed single scleral closure technique (100% versus 58%, P < 0.05) and endogenous endophthalmitis (50% versus 0%, P < 0.05) were associated with implant exposure or extrusion, and only endogenous endophthalmitis was significant with multivariate analysis (P < 0.05).
Conclusions: Primary implant placement during evisceration should be avoided in eyes with endophthalmitis especially in those with an endogenous source, and double scleral closure technique may be a better alternative for primary orbital implant placement in infected eyes.
(© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)
Databáze: MEDLINE
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