Evisceration; Traumatic, Eye Clinical Trial
Official title:
Comparative Motility of Retro-scleral and Intrascleral Orbital Implants After Evisceration
This study will evaluate the effect of posterior placement of orbital implants on their motility compared to intrascleral placement after evisceration .
Evisceration allows removal of the intraocular contents while preserving the sclera and
normal extraocular muscle attachments. It is more advantageous than enucleation in patients
in whom intraocular tumor is rules out.
Maximizing orbital volume and restoration of movement are important aspects of a successful
surgical outcome.
Standard evisceration techniques do not allow placement of an implant larger than 13-16 mm
which don't adequately replace the volume leading to postevisceration socket syndrome.
Therefore, various techniques have been described to expand the scleral cavity and allow
placement of a large implant including anterior sclerotomies, posterior sclerotomies, and
disinsertion of optic nerve.
Implant exposure is a terrible complication of evisceration with reported rates as high as
67%. Exposure of the implant can lead to infection, which usually mandates removal of the
implant. Trying to minimize this risk, physicians intentionally place the implants posterior
to the normal position of the globe. Some authors described placement of the implant
posterior to posterior sclera which totally eliminated the risk of exposure.
However, this deep seating of the implant may have deleterious effects on its motility. It
can decrease implant-prosthesis interaction. In addition, retro-scleral placement of the
implant moves it posterior to the pulleys that serve as the functional origins of rectus
muscles. This relationship would be expected to alter the pulling directions of the rectus
muscles after evisceration hindering effective implant motility.
In this trial the investigators will try to study the effect of posterior placement of the
implants on its motility after evisceration.
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Status | Clinical Trial | Phase | |
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Completed |
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