Predisposing Factors and Timing of Orbital Implant Exposure/Extrusion Following Enucleation or Evisceration: An 11-year study
Keywords:
orbital implant extrusion, orbital implant exposure, evisceration, enucleationAbstract
Purpose
Enucleation and evisceration are surgical procedures to remove a diseased eye. An extrusion/exposure of the orbital implants is the most common post-operative orbital implant-related complication. This study aimed to identify the incidence, timing, and possible risk factors of orbital implant exposure/extrusion in patients who underwent enucleation or evisceration.
Methods
The medical records of patients diagnosed with “exposure/extrusion orbital implant” following enucleation or evisceration at Chiang Mai University Hospital between January 2007 and December 2017 were retrospectively reviewed. Multivariable regression analysis was performed to identify the possible predicting factors.
Results
Overall, 466 patients underwent either enucleation (313/466, 67.17%) or evisceration (153/466, 32.83%). Three hundred twelve patients (312/466, 67.16%) were male. The age ranged between 0 and 94 years. The incidence of exposure/extrusion was 12.14% (38/313) in the enucleation group and 17.65% (27/153) in the evisceration group. The most common indication for surgery was ocular infections (218/466, 46.78% patients). Using multivariable regression analysis, older age (p=0.008) and HIV infection (p<0.0001) were significantly associated with the occurrence of exposure/extrusion in patients who underwent enucleation but not the evisceration.
Conclusion
The incidence of extrusion/exposure of the orbital implants following enucleation or evisceration was not uncommon. We identified older age and HIV infection as possible risk factors of orbital implant exposure/extrusion in patients who underwent enucleation. In most cases, the complications occurred within a month following the enucleation (18/38, 47.37% patients) and during 1-12 months following the evisceration (16/27, 59.26% patients), suggesting the appropriate follow-up frequency and period.
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