Continuous versus Interrupted Sutures for Closure of Scleral Pocket and Conjunctiva after Evisceration and Placement of Acrylic Ocular Implant.

Abstract

Introduction: Various methods of conjunctival closure have been described, with no consensus of preference. We designed this study to compare continuous versus interrupted sutures for closure of scleral pocket and conjunctiva after evisceration and acrylic ocular implant installation.

Methods: This study was a retrospective comparative observational study conducted at South Valley University Hospital on all ocular evisceration cases with acrylic implants from 1 March 2019 to 31 March 2024. For each patient, clinical data were perused, including demographics, indications, clinical history, operative details, and postoperative follow-up data.

Results: Forty-seven patients were included in this study. Twenty-seven were allocated to group A (continuous sutures) and 20 patients to group B (interrupted sutures). The mean age of patients was 38.52 ± 12.8 and 39.35 ± 14.5 in groups A and B, respectively (p value = 0.839). Males represented 51.9% (14/27) and 50% (10/20) of groups A and B, respectively (p value = 0.901). Absolute glaucoma was the indication in 5 (18.5%) and 3 (15%) patients in groups A and B, respectively; anterior staphyloma was the indication in 7 (25.9%) and 5 (25%) patients, respectively; and atrophia/phthisis was the indication in 6 (22.2%) and 5 (25%) patients, respectively, while old trauma was the indication in 9 (33.3%) and 7 (35%) patients, respectively, with p value = 0.769. The median size of the acrylic implant used was 20 mm in both groups. Patients were followed up on average in group A for 20.19 ± 3.2 months and in group B for 19.95 ± 3.4 months (p value = 0.812). No cases of infection or implant extrusion were observed in both groups. But in group B, there were 3 cases (15%) of wound dehiscence and implant exposure, while no reported cases in group A (0%) with clinically significant p value (0.029).

Conclusion: Continuous suturing for closure, as opposed to interrupted sutures, produces better wound outcomes when closing the scleral pocket and conjunctiva post evisceration and acrylic ocular implant installation.