The use of Osseointegration and Orbital Implants in the Management of Orbital Exenteration or Severe Contracted Sockets

Abstract

Objectives: To evaluate the results of bony integrated implants used in the management of exenterated or contracted sockets. Materials and Methods: Ten eyes of 10 cases underwent bony integrated implants for the management of exenterated (7 eyes) or contracted (3 eyes) sockets. The procedure was performed in two steps in a two-month period. The first step included placement of screws by preparing the osteotomy site, whereas the second step included implantation of magnetic implants over these screws that will adhere to the orbital implant. The patients were retrospectively evaluated for age, gender, etiology, surgical timing, history of radiotherapy, and time of application of epithesis. The presence of infection at the surgical site, implant loss, functional or cosmetic problems at the perisurgical area, the usage of epithesis during the social life were evaluated. Results: There were 7 female and 3 male patients. The mean age was 34 (5-75) years. The indications for enucleation or exenteration were: retinoblastoma (4 cases), malignant melanoma (2 cases), basal cell carcinoma (1 case), squamous cell carcinoma (1 case), rhabdomyosarcoma (1 case) and sinoorbital mucormycosis (1 case). The epitheses were applied 3 to 156 months (mean 51 months) following the intervention. All of the implantations were performed successfully. During follow-up, one case had lost the implant and one case had local infection that responded to antibiotic treatment. Three cases were reoperated and the implants were replaced after a 2-year follow-up time due to the deterioration of the magnetic effect of the implants. Conclusion: Bony integrated orbital implants have an important role in solution of esthetic problems encountered in the exenterated orbit and severe contracted socket. (Turk J Ophthalmol 2014; 44: 127-31)

Keywords

• Orbital epithesis
• extraoral orbital implants
• orbital prosthesis