Modified evisceration with posteriorly detached petals for management of deficient sclera

Omar A. E. Salama, A. Alkady, A. Tharwat
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Abstract

Aim The aim of this work was to evaluate the effectiveness of modified evisceration technique compared with standard technique in cases associated with deficient sclera. Patients and methods A prospective interventional study was conducted that included 34 eyes of 31 patients with deficient sclera scheduled for modified evisceration technique with intraconal placement of nonporous acrylic implants. Outcome was assessed in terms of implant extrusion, exposure, as well as other early or late postoperative complications. Results Adequate volume replacement was achieved in 32 (94.12%) of 34 eyes. Overall, two (5.88%) eyes had mild upper sulcus deficit, and three (8.8%) eyes had mild to moderate prominence of the prosthesis compared with the fellow eye, but no true exposure, extrusion, migration, socket contracture, or sympathetic ophthalmia was encountered. All of the patients were satisfied with the cosmetic and functional outcomes of the procedure, except for the two (5.88%) cases with upper sulcus deficit. Conclusion A modified evisceration technique for deficient sclera provides superior cosmetic and functional results compared with the standard technique. It has the advantage of allowing placement of relatively large orbital implants in cases associated with insufficient sclera with very low rates of implant extrusion, exposure, migration, or socket contracture.
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改良后瓣摘除术治疗巩膜缺损
目的本研究的目的是评价改良的内脏摘除技术与标准技术在巩膜缺陷病例中的有效性。患者和方法对31例34眼巩膜缺损患者进行了前瞻性介入研究,计划采用改良的摘除技术,在巩膜内放置无孔丙烯酸植入物。结果根据种植体挤压、暴露以及其他早期或晚期术后并发症进行评估。结果34只眼中32只(94.12%)完成了足够的体积置换。总体而言,2只(5.88%)眼有轻度上沟缺损,3只(8.8%)眼与同眼相比有轻度至中度假体突出,但未出现真正的暴露、挤压、移位、眼窝挛缩或交感眼炎。除上沟缺损2例(5.88%)外,所有患者均对手术的美观和功能结果满意。结论改进的巩膜缺损全内脏摘除技术与标准技术相比,具有更好的美观性和功能性。它的优点是允许在巩膜不足的病例中放置相对较大的眶内植入物,并且植入物的挤压、暴露、迁移或窝挛缩率非常低。
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发文量
8
审稿时长
19 weeks
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