Orbital volume deficiency measurement after enucleation

Abstract

Abstract: : Purpose:To establish a simple method for orbital volume deficiency measurement after enucleation and assessing necessary volume replacement in secondary orbital implant procedures. Methods:Perforated swimming goggles were placed to cover the left and right orbit. With the patient in a supine position, the perforation could be used as a water level to hold the surface of the goggles in a horizontal plane. The amount of water that could be filled into the goggles was used as an indirect measure of orbital volume difference between left and right in 15 healthy normal volunteers(13 men, 3 women). Volume differences were measured in 16 patients (12 men, 4 women) at a minimum of 15 months after surgical removal of the eyeball. Hertel exophthalmometry was used as a secundary measurement. Volumetric measurements were used to assess the amount of volume replacement prior to secondary dermis–fat grafting in 8 patients and defined the amount of tissue transplanted at the time of operation. Results: Orbital volume difference between right and left orbits in normal healthy subjects was measured to be at a median of 1 ml (range 0–1,5 ml). Volume difference in patients after enucleation with orbital implants was 0 to 16 ml (median 5 ml). Differences in proptosis with Hertel exophthalmometry was 0–2 mm in normals and 0–9 mm (median 5 mm) after enucleation. Prosthesis volume was 1,6 – 2,5 ml (median 2,1 ml). Assessment of volume necessary for correction of post–enucleation volume deficiency by using the specially designed goggles showed to give adequate results for satisfactory augmentation. Conclusions: Orbital volume difference measurement between right and left orbits by using perforated swimming goggles is a simple and adequate technique to assess orbital volume deficiency after enucleation. It can be used safely to assess the amount of tissue necessary to correct post enucleation syndrome.

Keywords: orbit • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: systems/equipment/techniques