Porous orbital implant after enucleation in retinoblastoma patients: indications and complications

ABSTRACT This study aims to identify risk factors associated with complications in retinoblastoma patients following primary and secondary enucleations with porous implant placement. A retrospective case-control study was performed between 2010 and 2015. Data pertaining to subjects’ demographics, medical history, clinical, and pathological findings, implant characteristics and complications were collected. The analysis included 103 eyes of 101 patients age 27.8 ± 21.9 months undergoing enucleation for retinoblastoma. Postoperatively, 19/103 (18%) eyes developed exposure, extrusion, or hematoma requiring subsequent surgery. Exposure was the most common postoperative complication (12/19, 63%). Age at enucleation 24 months or younger, Hispanic ethnicity, female gender, and intravenous chemotherapy prior to enucleation were associated with increased odds of implant complications. In contrast, patients who were given intravitreal melphalan (IM), subtenons carboplatin (SC), or external beam radiation therapy (EBRT) did not demonstrate an increased risk of complications. In this cohort of retinoblastoma patients undergoing primary or secondary enucleation with porous implants, implant exposure was the most common postoperative complication. Our findings suggest that female gender, Hispanic ethnicity, age at enucleation 24 months or younger, and intravenous chemotherapy prior to enucleation may increase the risk of complications.

[1]  H. Heimann,et al.  Porous Versus Nonporous Orbital Implants After Enucleation for Uveal Melanoma: A Randomized Study. , 2017, Ophthalmic plastic and reconstructive surgery.

[2]  C. Barut,et al.  Evaluation of Eyeball and Orbit in Relation to Gender and Age. , 2016, The Journal of craniofacial surgery.

[3]  N. Schalij-Delfos,et al.  Donor sclera‐wrapped acrylic orbital implants following enucleation: experience in 179 patients in the Netherlands , 2016, Acta ophthalmologica.

[4]  A. Moll,et al.  Orbital implants in retinoblastoma patients: 23 years of experience and a review of the literature , 2016, Acta ophthalmologica.

[5]  S. Schellini,et al.  Porous and nonporous orbital implants for treating the anophthalmic socket: A meta-analysis of case series studies , 2016, Orbit.

[6]  J. Perry,et al.  Medial Orbital Wall Landmarks in Three Different North American Populations , 2015, Orbit.

[7]  Sanket U. Shah,et al.  Hydroxyapatite Orbital Implant in Children Following Enucleation: Analysis of 531 Sockets , 2015, Ophthalmic plastic and reconstructive surgery.

[8]  Sara Ferraris,et al.  Biomaterials for orbital implants and ocular prostheses: overview and future prospects. , 2014, Acta biomaterialia.

[9]  Y. Yu,et al.  Outcome of smooth surface tunnel porous polyethylene orbital implants (Medpor SST) in children with retinoblastoma , 2013, British Journal of Ophthalmology.

[10]  C. Rodríguez-Galindo,et al.  Pediatric anophthalmic sockets and orbital implants: outcomes with polymer-coated implants. , 2013, Ophthalmology.

[11]  C. Rodríguez-Galindo,et al.  The effect of cancer therapies on pediatric anophthalmic sockets. , 2011, Ophthalmology.

[12]  S. Honavar,et al.  Implant and prosthesis movement after enucleation: a randomized controlled trial. , 2010, Ophthalmology.

[13]  H. Lew,et al.  Exposure rate of hydroxyapatite orbital implants a 15-year experience of 802 cases. , 2008, Ophthalmology.

[14]  L. Lin,et al.  Porous orbital implants, wraps, and PEG placement in the pediatric population after enucleation. , 2007, American journal of ophthalmology.

[15]  K. Trinkaus,et al.  Porous Implant Exposure: Incidence, Management, and Morbidity , 2007, Ophthalmic plastic and reconstructive surgery.

[16]  L. Lin,et al.  Prevention of exposure of porous orbital implants following enucleation. , 2007, American journal of ophthalmology.

[17]  J. Augsburger,et al.  Enucleation With Unwrapped Porous and Nonporous Orbital Implants: A 15-Year Experience , 2004, Ophthalmic plastic and reconstructive surgery.

[18]  Y. Yu,et al.  Management of porous polyethylene implant exposure in patients with retinoblastoma following enucleation. , 2004, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[19]  P. De Potter,et al.  Porous polyethylene orbital implant in the pediatric population. , 2004, American journal of ophthalmology.

[20]  S. Dresner,et al.  The smooth surface tunnel porous polyethylene enucleation implant. , 2004, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[21]  S. Kaltreider,et al.  Orbital implants in enucleation surgery: a report by the American Academy of Ophthalmology. , 2003, Ophthalmology.

[22]  H. Lemij,et al.  Comparison of artificial eye amplitudes with acrylic and hydroxyapatite spherical enucleation implants. , 2000, Ophthalmology.

[23]  B. Glasgow,et al.  Chronic Exposure of Hydroxyapatite Orbital Implants: Cilia Implantation and Epithelial Downgrowth , 2000, Ophthalmic plastic and reconstructive surgery.

[24]  N. Davies,et al.  Exposure of primary orbital implants in postenucleation retinoblastoma patients. , 2000, Ophthalmology.

[25]  J. O'Brien,et al.  Evaluation of efficacy and complications: primary pediatric orbital implants after enucleation. , 2000, Archives of ophthalmology.

[26]  R. Barretto,et al.  Orbital Measurement in Black and White Populations , 1999, The Laryngoscope.

[27]  P. Mullaney,et al.  Porous polyethylene orbital implant in patients with retinoblastoma. , 1998, Ophthalmology.