Abstract
Abstract: :
Purpose: Ocular prostheses are typically evaluated and replaced at infrequent intervals. Complications of poorly fitting ocular prosthetics include socket and lid contraction, ptosis, forniceal shortening, implant migration, and conjunctival/tenons tissue thinning leading to exposure/extrusion. We evaluated the benefit of prospective, serial prosthetic refitting to reduce socket complications, improve function and enhance cosmesis. Methods: 168 pediatric and adult patients who underwent enucleation and ocular prosthesis fitting were examined. Patients were prospectively evaluated at 4 to 6 month intervals and the following characteristics were graded on a scale of 1 through 5: prosthetic appearance, implant condition, fornices, and functioning ability. Information about the frequency of modification to fit, duration of prosthetic use, type and size of orbital implant were recorded. Statistical analysis evaluated dependent and independent variables correlating frequency of prosthetic refitting with life–table outcomes review. Results: In 168 eyes of 168 patients, we found no incidence of implant extrusion (0/168, 0%) Sockets that underwent aggressive refitting of the prosthesis at least once every 6 months were noted to have improved forniceal function, decreased conjunctival thinning, increased comfort and were graded with enhanced cosmetic appearance (p<.05). Conclusions: This study documents improved socket anatomy, function and enhanced cosmesis associated with serial prosthetic refitting. Prospectively evaluating the patient with an enucleated socket and targeting prosthetic modifications decreases major complications including implant extrusion.
Keywords: orbit • clinical (human) or epidemiologic studies: outcomes/complications • anatomy